Credit ApplicationTo Be Filled Out by Applicant Intersect, IncAddress:4744 W. Salix Ct.Meridian, ID 83646Phone:509-255-9570Fax:509-255-6034 Company Name * Address * In Business Since * Email * Phone * (###) ### #### Fax Number * Type of Company * Federal Tax ID # * Principals/Owners * Title * Contact Name * Contact Email * Contact Phone Number * (###) ### #### Name of Principal Bank * Address * Phone * (###) ### #### Fax Number * Taxable? * Yes No Send Invoice Via * Email Mail Pay Via * (if ACH, please email ACH form to sammie.arnold@intersectinc.com) Check ACH Credit references — This form will not be accepted without references REFERENCE ONE * First Name Last Name Address * Phone * (###) ### #### Fax Number * Email * REFERENCE TWO * First Name Last Name Address * Phone Number * (###) ### #### Fax Number * Email * REFERENCE THREE * First Name Last Name Address * Phone * (###) ### #### Fax Number * Email * Thank you!
