Meckley's Limestone Products

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Application Information - please fill out all information and then click on the Submit Application button below.
We can contact you to complete missing information;
just be sure to type in a phone number where you can be reached.

Company Name
Federal EIN Number
Address
City, State, Zip
Accounts Payable Contact
Phone Number
Years in Bus. under this Name
Email
Years at this Location
Date
D&B Number
Type of Business (Choose One)
If Corporation, What State?
Credit Line Requested	$
No. of Employees
Sales Volume

Ownership

Name of Owner		Phone
Home Address
Name of Owner		Phone
Home Address
Name of Owner		Phone
Home Address

Trade Reference

Company Name		Phone
Address
Company Name		Phone
Address
Company Name		Phone
Address

Bank Reference

Name of Bank		Phone
Address
Name of Bank		Phone
Address

By clicking on the Submit Application button below, I agree to the following:
If approval is given for the sale of merchandise without immediate payment, I agree to make full payment within terms of each such sale. If I default upon such obligation I agree to the assessment of a late payment charge in the amount of 1-1/4% per month (an annual rate of 18%) calculated upon the unpaid balance.

All statements made herein are true and accurate to the best of our knowledge. We authorize the above company to make any and all inquiries necessary for action on this credit application. We hereby indemnify the above company and its agents, from any liability resulting from their credit survey.

Name of Submitter
Title of Submitter
Date