CUSTOMER FINANCIAL AND CREDIT REFERENCES

Credit references should be companies with which you have accounts and terms of similar size and conditions as those being requested from The Platinum Packaging Group.

"*" indicates required fields

Bank Name*

Contact Person*

Address*

Email*

Phone Number*

Fax Number

Creditor 1

Contact Person

Address

Phone Number

Fax Number

Email

Current Terms

Current Limit

Current Balance

Creditor 1

Contact Person

Address

Phone Number

Fax Number

Email

Current Terms

Current Limit

Current Balance

Creditor 1

Contact Person

Address

Phone Number

Fax Number

Email

Current Terms

Current Limit

Current Balance

Terms and Credit Limit Requesting from The Platinum Packing Group

Terms Requested

Credit Limit ($)

Order Frequency

Please provide a predetermined amount and specify whether weekly, monthly, or annually.

Initial Order ($)

We/I currently maintain an Annual Sales Volume of

Authorized Signature

I certify that I am a representative of the above referenced company authorized to release the above information to The Platinum Packaging Group. To the best of my knowledge all information provided above is correct. I hereby authorize The Platinum Packaging Group to check references and other pertinent data.

Authorized Person

Printed Name

Title

Signature

Date

CAPTCHA

10104

CUSTOMER FINANCIAL AND CREDIT REFERENCES

Authorized Signature

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Supporting Documentation