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Application for Credit
Rimol Greenhouse Systems, Inc. .
40 Londonderry Turnpike
Hooksett, NH 03106
1 877 746-6544
For an Application to FAX or Mail
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Address to the Left
1 603 629-9023
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Company
Tax ID:
Telephone
Address
  
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City
State
 Zip
Contact Name
Email
Type of Organization
Length of Time in Businss
 
 

Background Information
Officers and/or Owners
NAME ADDRESS TITLE SSAN
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Person to contact for Payment  
Financial Institution Information
BANK - CHECKING
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BANK - SAVING
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Address Phone
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BANK - OTHER
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Trade References
(Please List three trade references in the agricultural industry)
TRADE REFERENCE 1
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Address Phone
City    State    Zip Fax
TRADE REFERENCE 2
Name Contact
Address Phone
City    State    Zip Fax
TRADE REFERENCE 3
Name Contact
Address Phone
City    State    Zip Fax
ADDITIONAL INFORMATION AND COMMENTS

I, do hereby Certify that the statements and information on this application are true to the best of my knowledge and belief.

I UNDERSTAND THAT CLICKING "APPLY" IS THE LEGAL EQUIVALENT OF MY MANUALLY SIGNING THIS APPLICATION.

In accordance with the Electronic Signatures in Global and National Commerce Act (E-Sign), your typed written signature constitutes a legal and binding application agreement that implies the information contained within is accurate to the best of your knowledge and belief.

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