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Credit Application

1 Step 1
Is your billing and shipping address the same
Reference #1
Reference #2
Reference #3
I agree to the terms below

Applicant's signature attests financial responsibility, ability, and willingness to: Pay our invoices in accordance with terms stated on invoices. There will be a 1.5% per month service charge on invoices past due. The above information is for the purpose of obtaining credit and is warranted to be true. We hereby authorize Couplings Company, Inc. to investigate the references listed pertaining to our credit and financial responsibility. This application will be regarded as confidential material.

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