Commercial Application Commercial Application SALESPERSON * DIVISION * Type of Account * Corporation Sole Proprietorship Partnership General Limited Name of Entity: * Phone No. * Primary Contact: * Secondary Contact: Address * Address Address Address City City State State Zip Zip Years in Business * Tax ID * Type of Products * Credit Limit Requested * Are You Bonded? * COMMERCIAL BANK Name * CITY/STATE * Phone * HIGH * OFFICER * PRODUCTION LENDER Name * CITY/STATE * Phone * HIGH * OFFICER * PRIMARY SUPPLIERS Name * CITY/STATE * Phone * HIGH * OFFICER * plus1 Add minus1 Remove In the last 15 years have you been in bankruptcy or had any judgments filed against you? Business References * OTHER INFORMATION: * I (We) warrant that the information provided on this application is, to the best of my (our) knowledge, true, correct, and complete. The additional information provided is also a complete and accurate presentation and may be relied upon by Scott Petroleum in their decision making process. You can read Terms And Conditions * I accept the Terms A Scott Petroleum representative will reach out for additional sensitive data to complete the application. Submit If you are human, leave this field blank.
