APPLICATION FOR CREDIT
					Date				20
ISSUED TO:		FUSECO INC.
		(Please answer all questions.  When no figures are inserted, write word "NONE")
FIRM NAME					TRADE STYLE
STREET ADDRESS						PHONE
CITY			STATE			ZIP CODE
FULL NAME OF OWNER OR OWNERS (OR AN AUTHORIZED OFFICER OF THE CORPORATION) LIST HOME ADDRESS &
ZIP CODE FOR PARTNERSHIP OR INDIVIDUAL
		INDIVIDUAL	PARTNERSHIP		CORPORATION		FED. TAX NO. (CORPORATION)			SOCIAL SECURITY#
PLEASE CHECK ONE
TYPE OF BUSINESS							DATE STARTED
ESTIMATED ANNUAL SALES
FORMER BUSINESS							LOCATION
OWN OR RENT BUILDING - IF RENT - FROM WHOM									VALUE
REAL ESTATE MORTGAGE
				TRADE REFERENCES
NAME					ADDRESS				PHONE#
NAME OF BANK
STREET ADDRESS
CITY					STATE
APPLICANT'S SIGNATURE ATTESTS FINANCIAL RESPONSIBILTY, ABILITY AND WILLINGNESS TO PAY OUR
INVOICES IN ACCORDANCE WITH THE FOLLOWING TERMS:
	I/we understand that all invoices are payable on/or before the 10th prox as shown on each invoice.  If not paid
	on/or before due date, the account is delinquent.  If credit is granted, I/we agree to the above terms and the
	undersigned is/are responsible for payment of this account.  You may charge reasonable attorney's fees if
	placed with an Attorney for collection or suit.  All charges on this account are due and payable at
	Fuseco Inc, Dallas County, Texas.
The above information as well as that given on the reverse						FIRM NAME
side is for the purpose of obtaining credit and is warranted
to be true.  I/we hereby authorize the firm to whom this						BY
application is made to investigate the references listed								TITLE
pertaining to my/our credit and financial responsibilty.
						BY
								TITLE
If you need a resale/exemption certificate or terms/conditions of sales please click one of the following links:
RESALE OR EXEMPTION CERTIFICATE.htm
TERMS AND CONDITIONS OF SALE AGREEMENT.htm