Full Name:        
Fin #:
Address:      
Years at address:
City: State: Zip:
Phone:


Darrin Sullivan CFO
Yale Equipment & Services, Inc 
W136 N4901 Campbell Drive
Menomonee Falls, WI  53051               


Hereby applies for credit in accordance
with the terms and conditions of:
Parts, Service, and Rental invoice terms - NET 10 
Equipment invoices – DUE UPON RECEIPT
Trade References


1. Principle(s) Name:
Phone:
  Address:
 
State:
Zip:
     


2. Principle(s) Name:
Phone:
  Address:
 
State:
Zip:
     
 


Principle(s) Name:
Phone:
Address:
State:
Zip:
   
3.
 
Ownership


Accts. Payable Contact Name: E-mail:
Phone Number: Fax Number:
Bank References


  Bank Name:
Phone:
  Address:
City:
State:
Zip:
 
Contact Information


Accts. Payable Contact Name: E-mail:
Phone Number: Fax Number:

We certify that all information on this form is correct.  We fully understand your credit terms and agree to the proper payment in consideration of credit extended.

Signed:
Date:
Title:
   
 
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