NAMCO CREDIT APPLICATION

Please fill-in all fields and click "format for printing" at the bottom of the page. You will then be required to print out the credit application, sign it, and fax it to 860 646-3692 or mail it to NAMCO. for approval.
Text in teal indicates that a response is required for that field.

Application Information:

Company Name:
Mailing Address:
Mailing Address (continued):
City:
State/Province:
Zip/Postal Code:
Accounts Payable Contact:		Phone Number:
Number of Employees at this location:
Number of years at this location?
Credit Line requested?	$

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Trade Reference:

1 Company Name:
Mailing Address:
Mailing Address (continued):
City:
State/Province:
Zip/Postal Code:
Phone Number:		Fax Number:

2 Company Name:
Mailing Address:
Mailing Address (continued):
City:
State/Province:
Zip/Postal Code:
Phone Number:		Fax Number:

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Bank Reference:

1 Name of Bank:
Address:
Address (continued):
Phone Number:
Fax Number:

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