MEGAMET INDUSTRIES, INC.

POST OFFICE BOX 635

BIRMINGHAM, AL 35201

(205) 322-7700      FAX(205) 322-4600

WATTS (888) 322-7750

 

CREDIT APPLICATION

 

COMPANY NAME:______________________________________________________

 

FEDERAL I.D.  # :_______________________________________________________

 

ADDRESS:______________________________________________________________

 

CITY:_______________________________STATE:__________ZIP:______________

 

CORP._________________PARTNERSHIP________________PROP.____________

 

SALES TAX #_______________________ YRS IN BUSINESS:__________________

 

TELEPHONE # ___________________ FAX # _______________________________

 

OFFICERS OF COMPANY: ( PLEASE LIST)

 

PRESIDENT:_____________________ VICE PRESIDENT:____________________

 

SECRETARY:____________________ TREASURER:_________________________

 

CONTROLLER/ BOOKEEPER: __________________________________________

 

BANK REFERENCES:

 

BANK NAME:_________________________ACCOUNT # _____________________

 

ADDRESS: _________________________ CITY:_________________STATE:______

 

ZIP:______________________TELEPHONE:________________________________

 

TRADE REFERENCES:

 

NAME:                                   ADDRESS:                                        TELEPHONE: