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Credit Application

Date :

Phone :

Business Name :

Fax :

Address :

City :

State :

Country :

ZIP :

Length of Business Ownership :

Ownership is :

Individual

Partnership

Corporation

Are you a :

Division

Subsidiary

Branch

Officer Name :

Title :

Officer Name :

Title :

Officer Name :

Title :

Trade References

Name :

Phone :

Fax :

Address :

City :

State :

ZIP :

Name :

Phone :

Fax :

Address :

City :

State :

ZIP :

Name :

Phone :

Fax :

Address :

City :

State :

ZIP :

Name :

Phone :

Fax :

Address :

City :

State :

ZIP :

Bank References

Name :

City & State :

Phone :

Type of Account :

Account # :

Years with Bank :

Bank Contact

Name :

City & State :

Phone :

Type of Account :

Account # :

Years with Bank :

Bank Contact

I hereby apply for an open credit account with Kahn Steel Co., Inc. located in Kansas City, MO. and Steamboat Springs, CO. With my full knowledge and consent, I do hereby authorize our bank(s) to release information regarding any deposit and/or loan accounts.

If open credit terms are approved, I understand and agree to pay for purchases within the standard terms (currently 1/2% 10, NET 30 DAY) of Kahn Steel Co., Inc. I will pay finance charges for amounts outstanding beyond such terms of 1 1/2% per month (18% annually).

Signature :

Title :

Date :

FINANCIAL INFORMATION – Please attach your latest prepared financial statement for the purpose of establishing your credit. All financial information will used solely for the purpose of evaluating credit worthiness and will be held in strict confidence.

TAX EXEMPT INFORMATION – We are required to charge applicable sales tax unless you provide us with a signed copy of your state’s exemption form. Contact our credit department if you need a blank form.