Credit Application

Please supply names of four (4) Trade-Related firms where you have established credit terms. Please do not list hardware companies, office suppliers or credit card companies.

(1)
Supplier Name: __________________________________ Telephone:(___)_____________

Street: ______________________________________________________________________

City: _____________________________________ State: ____________ Zip: ___________

Type of Materials Supplied: _______________________________________________________

(2)

Supplier Name: __________________________________ Telephone:(___)_____________

Street: ______________________________________________________________________

City: _____________________________________ State: ____________ Zip: ___________

Type of Materials Supplied: _______________________________________________________

(3)

Supplier Name: __________________________________ Telephone:(___)_____________

Street: ______________________________________________________________________

City: _____________________________________ State: ____________ Zip: ___________

Type of Materials Supplied: _______________________________________________________

(4)

Supplier Name: __________________________________ Telephone:(___)_____________

Street: ______________________________________________________________________

City: _____________________________________ State: ____________ Zip: ___________

Type of Materials Supplied: _______________________________________________________

Please mail this form along with a completed Sales Tax Exemption card to:

Century Graphics & Metals, Inc. 3497 All American Blvd. Orlando Fl. 32810 Toll Free 800-327-5664 /

Fax 407-578-5567 / Local 407-295-7818

Date: ____________

Signature: ___________________________________ Title: ______________________