Credit Application

CUSTOMER NAME:	DBA:
ADDRESS:	STATE:	ZIP:
CITY:
TELEPHONE:	FAX:
OWNER'S NAME:	BUYER'S NAME:
ACCOUNT PAYABLE/BOOKKEEPER'S NAME:
J.B.T. NUMBER:	ARE YOU INCORPORATED? YES NO
NUMBER OF YEARS IN BUSINESS:	CREDIT LIMIT NEEDED: $
DO YOU CARRY FULL INSURANCE? YES NO
WILL YOU PROVIDE AN UP-TO-DATE FINANCIAL STATEMENT: (IF SO PLEASE FORWARD)
	.

T R A D E R E F E R E N C E S

1.	COMPANY NAME:
	STREET ADDRESS:
	CITY:		STATE:	ZIP:
	TELEPHONE:		FAX:
	CONTACT PERSON:
		.
2.	COMPANY NAME:
	STREET ADDRESS:
	CITY:		STATE:	ZIP:
	TELEPHONE:		FAX:
	CONTACT PERSON:
		.
3.	COMPANY NAME:
	STREET ADDRESS:
	CITY:		STATE:	ZIP:
	TELEPHONE:		FAX:
	CONTACT PERSON:

B A N K R E F E R E N C E
	BANK NAME:
	STREET ADDRESS:
	CITY :	STATE:	ZIP:
	TELEPHONE:	FAX:
	PERSON TO CONTACT:

AUTHORIZATION FOR BANKS TO RELEASE INFORMATION

The undersigned hereby authorizes: (Name of bank) to release information on my / our account's) to China Pearl, for the purpose of establishing credit terms. It is agreed and understood that the undersigned will hold harmless the companies engaging in the exchange of such information and understands that the information provide is for determining credit worthiness as a routine business practice. China Pearl Import, assures the confidentiality of the information provided and makes no claims toward the accuracy of such information received.

_________________________

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Authorized Signature Date Company Name

I agree to pay service charge at 1 1/2 % per month if my account becomes delinquent. If I do not pay service charges and my account becomes delinquent, I understand that my terms may be put on a proforma basis..

__________________________________
Authorized Signature