CREDIT APPLICATION
**PLEASE PRINT, COMPLETE, AND FAX TO OUR OFFICE FOR PROCESSING**
ELECTRICAL CONTRACTORS, INC
1252 ALLANSON ROAD
MUNDELEIN, IL  60060
PHONE 847-949-0134 FAX 847-566-0162
FIRM NAME:			YEARS IN BUSINESS:
STREET ADDRESS:
CITY/STATE/ZIP:
PHONE:
NAME OF OWNERS/OFFICERS:			TITLE:
				INDIVIDUAL
				CORPORATION
				BUSINESS
HAVE YOU EVER OPERATED UNDER ANOTHER NAME?			Y		N
IF YES, NAME OF COMPANY:
HAVE YOU EVER DECLARED BANKRUPCY?			Y		N
TRADE REFERENCES (Minimum of three, doing business for over one year)
Name:		Phone:
Address:		Fax:
Name:		Phone:
Address:		Fax:
Name:		Phone:
Address:		Fax:
BANK:		Phone:
Address:		Fax:
Account:
Representative:
The undersigned certifies the above credit information is correct and authorizes and
directs the above indicated bank and business references to verify said information and
to give additional information upon request.
FIRM NAME:					DATE:
SIGNATURE:
PRINT NAME:
TITLE:
NOTE:  THIS APPLICATION MAY TAKE UP TO TWO WEEKS TO PROCESS.  PROCESSING TIME DEPENDS UPON THE RESPONSE TIME BY YOUR CREDIT REFERENCES.