Credit Application and Update
Date:		Corporate Name:
Billing Address:		City:	State:  ZIP:
Shipping Address:		City:	State:  ZIP:
Phone:		FAX:
Date Formed:		Company Type:	Corporation Partnership Proprietorship
List Corporate Offices/Company Owners and % of ownership (ex. John Smith - 12%)
Type of Business:		How long in business:
What credit line you request:
Bank Name Account Number Contact Phone Number
Line of Credit:	$	Loans Outstanding:	$
Seafood Trade References Name Address Phone Number
Your Name:
Your Position:
Your Email:
By submitting this form, you authorize the above banks to release all credit information to the recipient of this form.