This form is the basis of a check into the credit history of a customer. With this form a company desiring credit furnishes various information which may be checked further to ascertain the reliability and background of the credit applicant.

The credit applicant is requested to furnish the following information:

· Company name and address and length of time in business
· Gross annual sales, net profits, and net value of the company
· Type of business
· Three bank references
· Three trade references
· Three credit references

In addition, the applicant is asked to request a credit limit for their account. Finally, the various credit terms which are being applied for are spelled out.

This form is for use in Maryland.