Vantage Lighting, Inc.

Distributors of Specially Lighting Products

1-800-445-2677
Please print both pages of credit application and fax completed forms to 1-415-507-0502, Attn: Credit Department.
For the purpose of obtaining merchandise from you on credit, the following statement made in writing is warranted to be true, intending that you should rely on same as correct. Applicant hereby authorizes the firm, or its agents, to whom application is made to investigate the references listed below to ascertain the undersigned's personal, partnership or corporate credit and financial responsibility.
APPLICANT:_______________________________________________________________________________________________
NAME OF BUSINESS:_______________________________________________________________________________________
FAX:___________________________________________ PHONE:____________________________
TYPE OF BUSINESS:________________________________________________________________________________________
MAILING ADDRESS:________________________________________________________________________
CITY:_____________________________________________ STATE:_________________________ ZIP:_____________
OWNERSHIP STYLE: CORPORATION______ PARTNERSHIP______ PROPRIETORSHIP______

FEDERAL ID# OR SS#

______________________

CREDIT LIMIT REQUESTED:

$________________________
FULL NAME (List all owners attach separate sheet if needed)_____________________________________________________
Home address:___________________________________________ Phone#_________________
_________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
DATE BUSINESS STARTED:_______________________
CURRENT OWNERS SINCE:_______________________
 
FORMER EMPLOYMENT OF OWNERS, (if business is less than 2 years old).______________________________________
Owner(s)________________________________ Address__________________________________ Phone___________________
__________________________________________________________________________________________________________
BUSINESS OR PROFESSIONAL LICENSES HELD:
State Classifications License No. Name issued under.
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
RESALE NO.________________________ (please fax copy of certificate) CONTRACTOR'S LICENSE NO._____________
NAME AND ADDRESS OF BONDING COMPANY:_____________________________________________________________
__________________________________________________________________________________________________________
AGENT:_____________________________________________ EXPIRATION DATE:________________________
ATTACH A COPY OF RECENT FINANCIAL STATEMENT
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