• JADCO INC.
• PO BOX 465
• Zelienople, PA 16063
• Phone: 724-452-5252
• Fax: 724-452-1318

Credit Application

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*Name of Company / Corporation
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*Address
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*ZIP/Postal Code
*Telephone
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ZIP/Postal Code
OTHER INFORMATION
*Number of years in Business
*Description of Business
Parent Company (If Applicable)
Address
City
State/Province	Select state/province Alabama Alaska Alberta Arizona Arkansas British Columbia California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland North Carolina North Dakota Northwest Territories Nova Scotia Ohio Oklahoma Ontario Oregon Pennsylvania Prince Edward Island Puerto Rico Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Yukon Territories Military -- AA Military -- AE Military -- AP Not Applicable
ZIP/Postal Code
*Bank
*Telephone No.
*City
*State/Province	Select state/province Alabama Alaska Alberta Arizona Arkansas British Columbia California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland North Carolina North Dakota Northwest Territories Nova Scotia Ohio Oklahoma Ontario Oregon Pennsylvania Prince Edward Island Puerto Rico Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Yukon Territories Military -- AA Military -- AE Military -- AP Not Applicable
TRADE REFERENCES
Name
Address
Fax
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Fax
Name
Address
Fax
*ANTICIPATED ANNUAL PURCHASES	$
*Customer Contact
*Phone
*E-Mail
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The applicant authorizes JADCO, Inc. to obtain a written or oral credit report from any credit reporting agency. The applicant further authorizes any bank or commercial business with whom the applicant is doing or has done business with to give any and all information to JADCO, Inc, which will assist JADCO, Inc in the credit investigation. The applicant further authorizes JADCO, Inc. to reinvestigate the applicant’s credit status from time to time as JADCO, Inc. deems necessary. Should JADCO, Inc., upon investigation, deem it necessary to limit or terminate the credit arrangement with the applicant, JADCO, Inc. shall do so.

The undersigned further agrees that should credit be extended and in the event the undersigned defaults in its credit arrangement with JADCO, Inc., the undersigned agrees to pay reasonable collection and attorney fees.