Credit Application Form

To apply for credit, please fill out the form below and hit the submit button. You may also download and print this form and fax it back to (214) 638-3609.

Customer Name		Date:
Address		D & B #:
		Rating:
Local References:
Name:		By:
Address:		Phone:
		Fax:
Name:		By:
Address:		Phone
		Fax:
Name:		By:
Address:		Phone
		Fax:
Out of Town References:
Name:		By:
Address:		Phone
		Fax:
Name:		By:
Address:		Phone
		Fax:
Name:		By:
Address:		Phone
		Fax:
	enter the word in this box:

Southwest Materials Handling Company 4719 Almond Street, Dallas, TX 75247       © 2011         (214) 630-1375 - Metro (972) 263-3016 - Fax (214) 638-3609