Creditapplication

Account Application

(A signed copy of your Texas Resale Certificate is required for approving your application)

Last

required

First

required

Title

Name of Business or Organization

required

DBA as and Division/Subsidary of

Type

In Business since

Tax I.D. Number

Address:

required

City

required

State

Zip.

Email

required

Confirm Email

Phone

Fax

Prefer to order flowers and supplies

Directives/Owners Information

Complete Name of 1st. Person Responsible of Business Transactions

Address:

required

City

required

State

Zip.

Complete Name of 2nd. Person Responsible of Business Transactions

Address:

required

City

required

State

Zip.

Bank References

1st Institution Name

Account #

Phone

Address

City

required

State

Zip.

2nd Institution Name:

Account #

Phone

Address

City

required

State

Zip.

Trade References

1st Company Name

Contact Name

Account Open Since

Address

City

required

State

Zip.

Credit Terms

Credit Limit

Current Balance

2nd Company Name

Contact Name

Account Open Since

Address

City

required

State

Zip.

Credit Terms

Credit Limit

Current Balance

Attach Signed Copy of Texas Resale Cert.

up to 400 Kb

Attach Signed Copy of Personal Guaranty

up to 400 Kb

Attach Signed Copy of Credit Card Auth.

up to 400 Kb

I hereby certify that the information contained herein is complete and accurate. This information has been furnished with the
understanding that it is to be used to determine the amount and conditions of the credit to be extended. Furthermore, I hereby authorize the financial institutions listed in this credit application to release necessary information to the company at which credit is being applied
for in order to verify the information contained herein.

Signature

Date