Welcome To VMC Inc.

VMC Enterprises, Inc.
Credit Application

First Name	M.I.	Last Name	SS# / SIN#	Birth Date \| MM/DD/YY

First Name	M.I.	Last Name	SS# / SIN#	Birth Date \| MM/DD/YY

Business Name	Tax ID# / GST#

Presidents First Name	M.I.	Last	SS# / SIN#	Birth date \| MM/DD/YY

Street Address	Mailing Address

City	State / Province	Zip / Postal Code

Home Phone	Business Phone	Business Type	Years in Business

Income Frequency	Income Amount $	Annual Expenses $

Main Lending Reference	Contact	Phone Number

Other Lending Reference	Contact	Phone Number

Checking Account	Savings Account	Bank	Phone Number
YES NO	YES NO

Have I/we had any unsatisfied judgments rendered against me/us in the past 7 years, had equipment repossessed in the past 7 years, or been declared bankrupt in the past 10 years?
Please explain below for any yes answer.

I/we understand and agree that you may assign or transfer this credit application and may also communicate the information contained herein to others to decide whether or not to extend credit. I/we authorize the bank and business references, as well as any of my/our lessors, landlords and any other past or present creditors to give any and all necessary information to you, your assignees or transferees, which will assist you in your credit inquiry. This application is given for the purpose of obtaining credit. I/We hereby certify under penalty of law that the foregoing is a true and complete statement of my/our financial condition. In the event of any material change in my/our financial condition, I/We will notify you immediately in writing.

Customers Signature	Date \| MM/DD/YY