Moore Manufacturing
71509 Old Cascade Hwy
P.O. Box 309
Skykomish, WA 98288- USACredit Application
Name of Company _______________________________________________________________________________
Corporate or legal buying name (if different)___________________________________________________________
Shipping Address Billing Address
Street ________________________________________ Street or Box __________________________________
City ________________________________________ City __________________________________
State ___________________ Zip _____________ State ______________ Zip _____________
Phone (_____)_______-_____________ Phone (_____)_______-_____________
Fax (_____)_______-_____________ Fax (_____)_______-_____________
Check one: Business is a Corporation ____ Partnership ____ Proprietorship ____
How long in business? ________________________________________________
Accounts Payable Person
Name ____________________________________Phone (_____)_______-__________ext________
Email __________________________________________
Bank Reference: Name of Bank __________________________ Branch _____________________
Contact _________________________________ Account Number _______________________________
Address _________________________________________ Phone (_____)_______-_____________
State ____________________ Zip _____________ Fax (_____)_______-_____________
Check here if cash sale is satisfactory until credit is approved (we also take VISA & M.C. cards) _____
Trade References
Name Address Phone Fax
_______________________ __________________________________ (____)____-______ (____)____-______
_______________________ __________________________________ (____)____-______ (____)____-______
_______________________ __________________________________ (____)____-______ (____)____-______
_______________________ __________________________________ (____)____-______ (____)____-______
_______________________ __________________________________ (____)____-______ (____)____-______
Signature _____________________________ Title ___________________ Date ____/____/_______