elite

personnel

Credit Application

BUSINESS NAME  _________________________________________________________________________________ 

CORPORATE NAME  ______________________________________________________________________________

Address  ______________________________________________  City  __________  State  ____  Zip Code  ________ 

Telephone  _______________________  Fax  _______________________  E-Mail  _____________________________

Year Company Established  _____________________________________  Federal Tax ID  _______________________

TYPE OF BUSINESS:    Corporation   ___      Partnership    ___      Proprietorship    ___

DESCRIPTION OF BUSINESS:  ______________________________________________________________________

PRINCIPLES:       Name  ______________________________________  Title  _________________________________

                            Name  ______________________________________  Title  ________________________________

    Name  ______________________________________  Title  ________________________________

CREDIT REFERENCES:

Name  _________________________________________________________   Account #  _______________________

Address  ______________________________________________  City  __________  State  ____  Zip Code  ________ 

Telephone  ______________________  Fax  ________________________  E-Mail  _____________________________

Date Last Used  ___________________

Name  _________________________________________________________   Account #  _______________________

Address  ______________________________________________  City  __________  State  ____  Zip Code  ________ 

Telephone  ______________________  Fax  ________________________  E-Mail  _____________________________

Date Last Used  ___________________

Name  ______________________________________________________   Account #  __________________________

Address  ______________________________________________  City  __________  State  ____  Zip Code  ________ 

Telephone  ______________________  Fax  ________________________  E-Mail  _____________________________

Date Last Used  ___________________

BANK REFERENCES:

Bank Name  ______________________________________  Contact Person  __________________________________

Address  ______________________________________________  City  __________  State  ____  Zip Code  ________ 

Telephone  ______________________  Fax  ________________________  E-Mail  _____________________________

Account Number  _____________________________________________    Date Last Used  ______________________

Signature  ________________________________________________________       Date  _____________

Print Signature  ___________________________________________________       Date  _____________

Terms for payment of invoices are 10 day net.  Invoices overdue by 30 days or more are charged 1.5% of balance due.  If a matter is turned over to an attorney for collection, all attorneys' fees are to be paid in full by the client.  Fees to hire an Elite Temporary Employee on a permanent basis are 20% of the annual starting salary for the position the Elite employee is being hired to fill.  Placement dues are the responsibility of the client.

3 Metro Center, Suite 510 Bethesda, MD 20814 Tel (301) 951-3333 Fax (301) 907-9522 E-Mail www.elitepersonnel.com