BEDROOMS DINING ROOMS DINETTES & BAR STOOLS WALLS & ENTERTAINMENT CTRS BARS OCCASIONAL TABLES HOME/OFFICE/COMPUTER FURN. LIVING ROOMS RECLINERS LAMPS RUGS JUVENILE FURNITURE & ACCESSORIES CONTRACT FURNITURE ACCESSORIES/AMENITIES Search Username Password Credit Application Form Print Out Order Form Home About Us Contact Us F.A.Q. Our Services		Name of firm or individual Years in business Address Type of business Address 2 Federal Tax ID City Phone State Fax Zip E-mail address Social Security Number Tax Exempt (if Applicable) Ownership Information The following information must be provided and will be held in the strictest confidence. Name(s) of principal(s) Address Phone Number Address 2 City State Zip Name(s) of principal(s) Address Phone Number Address 2 City State Zip Finance Bank Name Account # Branch Address City State Zip Bank Officer Phone # Name of account ( if different than company name ) References (all 4 required ) Company name Contact Name Phone Number Company name Contact Name Phone Number Company name Contact Name Phone Number Company name Contact Name Phone Number By signing below, I declare that the information provided is true, correct, and complete. In order to establish a line of credit, I authorize the above Bank/references to release any information necessary. Signature Title Date

Copyright 2002 All Rights Reserved www.apartmentfurnishers.com Site created by SmartWeb Design