Business Credit Reports

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Company Information

Company Name

Address

City

State/Province

Zip/Postal Code

Country

Nature of Business

Date Established

County

Type of Business

Federal I.D. #

Equipment Location (if different from above)

Contact Information

First Name

Last Name

Title

Phone

Principal Information – include all owners to account for 100% of company ownership

Primary Owner Legal Name

Title

Social Security Number

Date of Birth

Street Address

City

State

Zip

Phone

Additional Owner Legal Name

Title

Social Security Number

Date of Birth

Street Address

City

State

Zip

Phone

Bank Information

Bank

Account Number

Phone

Contact

Bank

Account Number

Phone

Contact

Trade Reference #1

Name

Phone

Contact

How Long?

Trade Reference #2

Name

Phone

Contact

How Long?

Trade Reference #3

Name

Phone

Contact

How Long?

Request

Requested Amount

Comments (400 characters max)

Terms

By signing below, I/WE here authorize LAT Enterprises, LLC, its heirs & assigns to obtain a personal report on all principals & guarantors for credit purposes, & (2) authorize the release LAT Enterprises, LLC of all credit information it may request, including business & personal banking, mortgage, landlord, trade & lease information.

I accept the above terms.

Please Sign Below

Using a touchpad or mouse, please sign in the area below. When finished signing, please click the Save Signature.

Submit the Request

By clicking 'Submit', I/We authorize LAT Enterprises, LLC or its agent to obtain a credit report for the purpose of establishing, maintaining or enforcing a credit relationship. Upon approval of credit, I/We agree to pay our account according to the terms granted and I/We acknowledge that I/We have read and fully understand this application.

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