Credit Application

Cookies United Credit Application Form

By submitting this application, you authorize (Company Name) to make inquiries into the banking and business/trade references that you have supplied.

Company Name*
Do You Have Your Own Credit Form To Submit?*
- Yes
- No
Upload Customer Credit App.
Max. file size: 50 MB.
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Fax*
Email*
Enter Email Confirm Email
Type Of Business*
- Sole Proprietorship
- Partnership
- Corporation
- Other - Specialty
DUNS #
Federal Tax #*
Estimated Annual Purchases*
Requested Credit Line Amount*
Business / Trade Reference 1
Company Name*
Company Contact*
Address
City State ZIP Code
Phone*
Email*
Business / Trade Reference 2
Company Name*
Company Contact*
Address
City State ZIP Code
Phone*
Email*
Business / Trade Reference 3
Company Name*
Company Contact*
Address
City State ZIP Code
Phone*
Email*
Signatures
Date*
MM slash DD slash YYYY
Title*
Name*
First Last
Signature*

Business / Trade Reference 1