Credit Application - Commercial Accounts Only
Institutions and individuals who would like to distribute our products may wish to have credit with CareTek Resources, Inc. If this is true of your company, please fill out the brief form below so that we can verify your credit history. If you already have an account with us please click here to continue on to the wholesale pricing.
   
Name:
Company:

Title Corporation
 Partnership
Individually Owned
Tax ID# (if applicable):
Street:
City:
State:
Zip:
E-mail:
Phone:
Fax:
How long in Business:
REQUIRED FIELDS

Names, Titles of Principles:

Name and addresses of three major suppliers from whom credit is obtained
Supplier #1:
Name:
Address:
City:
State:
Zip:
Supplier #2:
Name:
Address:
City:
State:
Zip:
Supplier #3:
Name:
Address:
City:
State:
Zip:
Name of Bank
Name:
Address:
City:
State:
Zip:
Phone:    
Checking A/C No.:    
Loan A/C No.:    

 
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