Employer Credit Application

Employer Application for Credit

Mandatory information required in order to extend credit.
.
Labor Temps-THE STAFFING COMPANY | Mesa (480) 835-3001 | (480)969-7009

Applicant Information
First Name:
Last Name:
Company:
SS#:
EIN#:
Select One:	Corporation
	Partnership
	Sole Proprietor
	Other
Bill Rate $:	(estimated for Credit Purposes)
Annual Sales $:
# of Years in Business:
SIC Code:
	Yes, Purchase Orders Are Required.
If yes, how often?:
.
Address Street 1:
Address Street 2:
City:
Zip Code:	(5 digits)
State:
.
Job #1 Description of Duties:
Equipment Needed:
W/C Code:
Approx. # of Employees per Day:
Bill Rate $:
.
Job #2 Description of Duties:
Equipment Needed:
W/C Code:
Approx. # of Employees per Day:
Bill Rate $:
.
Site Address + Site Directions + Travel time:
Co-Applicant Information
First Name:
Last Name:
Contact Information
Daytime Phone:
Evening Phone:
Email:
Financial Information
Bank Name:
Bank Address:
City/State/Zip:
Bank Phone #:
Account #:
Date Opened:
.
Loan Bank:
Address:
City/State/Zip:
Bank Phone:
Account #:
Date Opened:
Trade References
Company:
Contact:
Address:
City/State/Zip:
Telephone:
.
Company:
Contact:
Address:
City/State/Zip:
Telephone:
.
Company:
Contact:
Address:
City/State/Zip:
Telephone:
Other Information
Comments:	Enter comments here!
	I hereby certify that the information in this credit application is correct. Labor Temps and/or its agents are authorized to make investigations of our/my credit. The information provided will enable Labor Temps to determine the amount of credit and the conditions under which credit will be extended. I authorize the bank and trade reference listed above to release credit information on the company. Starting 30 Days after invoice date, interest will accrue at a rate of 1.5% per month or the highest amount allowed by law. In any dispute concerning this agreement, the prevailing party will be entitiled to recover its legal fees and expenses.