Credit Application

Commercial Credit Department

Business Credit Application

Complete all sections accurately. Applications are reviewed within 2-3 business days. Contact us at 205-595-3796 with any questions you may have.

Business Information

Legal entity details as registered with state authorities

Legal Business Name *

DBA / Trade Name

Federal Tax ID (EIN) *

Business Structure *

State of Incorporation *

Date Established *

Industry / Business Type *

Number of Employees

Annual Revenue (approx.) *

Business Address

Principal place of business - P.O. Boxes not accepted

Street Address *

City *

State *

ZIP Code *

Business Phone *

Business Email *

Website

Property Status *

Years at Current Address

Credit Request

Details of the credit line or terms being requested

Credit Limit Requested *

Preferred Payment Terms *

Purpose / Use of Credit *

Products / Services Needed

Instruments / GNSS Machine Control Drones / UAV LiDAR Scanners Software Supplies & Accessories Service / Repair Marine Systems

Banking Information

Primary business banking relationship

Bank Name *

Account Type *

Bank Branch / Contact

Bank Phone

Average Monthly Balance

Years with Bank

Trade References

Provide at least two vendors or suppliers who currently extend you credit

Reference 1

Company Name *

Contact Name

Phone *

Account # (optional)

Their Credit Limit to You

Years as Customer

Reference 2

Company Name *

Contact Name

Phone *

Account # (optional)

Their Credit Limit to You

Years as Customer

Reference 3 - Optional

Company Name

Contact Name

Phone

Account # (optional)

Their Credit Limit to You

Years as Customer

Principal / Owner Information

Primary owner or authorized officer completing this application

First Name *

Last Name *

Title / Position *

Ownership % *

Direct Phone *

Email *

Home Address

Social Security # (last 4 digits)

Certification & Signature

Read carefully - your typed name constitutes a legal electronic signature

By submitting this application, I/we certify that the information provided is true, accurate, and complete to the best of my/our knowledge. I/we authorize Earl Dudley, LLC to investigate the references listed herein, obtain credit bureau reports, and verify all information. I/we understand that misrepresentation or omission of any fact may result in denial or revocation of credit privileges. I/we agree to notify Earl Dudley, LLC of any material changes in the financial condition of the business. This application shall be deemed part of the credit agreement upon approval.

Authorized Signature Name *

Title *

Date *

Your Email (for confirmation copy) *

All information is handled securely. Our credit team will contact you within 2-3 business days.