Business Credit Reports

Existing Customer

Are You An Existing Customer? (Yes/No)

If Yes, What Is Your Account Number?

Company Information

Company Name

DBA

Address

City

State/Province

Zip/Postal Code

Country

Phone Number

DUNS #

Mailing Address, If Different

City/State/Zip

Phone Number

Delivery Address, If Different

City/State/zip

Phone Number

Legal Form (Corporation, LLC, Partnership, or Proprietorship)

Is The Business A Subsidiary Or Affiliate? (Yes/No)

Type of Business (i.e. Car Audio, Accessories, Hard Parts)

If Hard Parts, select one: Auto Repair / Service, Hard Parts Jobber, Dealership, Used Car Lot, Body Shop, Farm/AG

How Long In Business?

Own Or Rent?

If Rent, Name Of Landlord

Phone Number For Landlord

If You Have Inventory, Is It Used For Collateral? (Yes/No)

Contact Information

First Name

Last Name

Title

Phone

Purchasing Information

Will The Account Be Taxable or Non-Taxable?

Is A Purchase Order Required? (Yes/No)

Would You Like To Receive E-Mailed Invoices And Statements? (Invoices/Statements/Both/Neither)

Email Address For Invoices

Email Address For Statements

Payment Method? (Credit Card, Check, Cash, ACH)

Supporting Documentation

Please attach all fully completed tax forms that are relevant to this account. Not doing so could delay the approval process.

Click the Browse / Choose Files button above to select the files you want to send. Then click the Upload button.
Please keep individual file sizes to 4MB or less.

Uploaded Documents

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Submit the Request

By clicking 'Submit', I/We authorize Tri-State Enterprises (Credit App) 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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