Our Legal Entity Is:
Corporation 
Co-Partnership Proprietorship(If a Corporation, list names of officers and titles. If other entity, list names of partners or owners.)
Name Address City
Credit Application - Print This page, fill out, and fax to: 770 441-1806 Go Back
Humphries Building Products, Inc.
2830 Humphrles Way
Doravllle, GA 30360
(770) 441-9175 (770) 441-1806 Fax
Date:______________________________________________________________________________________________________________________
Name of Firm or Corporation:__________________________________________________________________________________________________
Street Address:______________________________________________________________________________________________________________
City: __________________________________________________________________ State Zip:___________________________________________
The following information is submitted for your consideration on a basis of extension of credit to us.
We operate
(Type of Business)___________________________________________________ We have been established_______years.
Our Legal Entity Is: Corporation Co-Partnership Proprietorship
(If a Corporation, list names of officers and titles. If other entity, list names of partners or owners.)
Name
Address
City
__________________________ ______________________________________ ___________________________________________________________
__________________________ ______________________________________ ___________________________________________________________
__________________________ ______________________________________ ___________________________________________________________
Annual Sales Volume: ____________ No. of Salesmen: _______________Monthly Credit Desired: ___________________________________________
The following are six trade references that we are presently doing business with:
Company Name
Street Address
City, State, Zip
__________________________________ ____________________________________________________ _____________________________________
__________________________________ ____________________________________________________ _____________________________________
__________________________________ ____________________________________________________ _____________________________________
__________________________________ ____________________________________________________ _____________________________________
__________________________________ ____________________________________________________ _____________________________________
__________________________________ ____________________________________________________ _____________________________________
We Bank at:
Bank Name
Street Address
City, State, Zip
__________________________________ ______________________________________________ ___________________________________________
__________________________________ ______________________________________________ ___________________________________________
Date: _______________________ Signed by: ________________________________________________Title:___________________________________
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AUTHORIZATION TO RELEASE INFORMATION
I HEARBY AUTHORIZE OUR BANK(S) TO RELEASE ANY INFORMATION NECESSARY TO ASSIST IN ESTABLISHING A LINE OF CREDIT.
Firm Name: __________________________________________________________________________________________________________________
Address: _____________________________________________________________________________________________________________________
City, State, Zip: _______________________________________________________________________________________________________________
Authorized by: ______________________________________________________ Title: ____________________________________________________