Ecopro, LLC
8000 Innovation Park Dr.
BLDG 3000 Baton Rouge, LA 70820
Phone 1-877-841-2345
Fax 225-578-3975
Commercial Credit Application
Company's Legal Name
Doing Business As (DBA), if different from legal
Business Street Address
City
Zip
State
Billing Address (if different from above)
City
State
Zip
Business Phone Number
Business Fax Number
Company Website
Fed Employer ID Number (EIN) (Tax ID)
Type of Entity
Name
Company Information
Principals/Ownership (Include Officers, Partners, Directors or Proprietor
Business Start Date
Annual Sales
Number of Employees
Home Address
Title
City
Ownership Percentage
Social Security Number
State
Zip
Home Phone
Name
Home Address
Title
City
Ownership Percentage
Social Security Number
State
Zip
Home Phone
Name
Home Address
Title
City
Ownership Percentage
Social Security Number
State
Zip
Home Phone
Bank References (include deposit accounts and loans/lines of credit, if applicable
Bank Name
Contact Person
Type of Account
Account Number
Address
City
State
Phone
Fax
Bank Name
Contact Person
Type of Account
Account Number
Address
City
State
Phone
Fax
Trade References
Vendor's Name
Contact Person
Phone
Fax
Address
City
State
Account Number
Vendor's Name
Contact Person
Phone
Fax
Address
City
State
Account Number
Vendor's Name
Contact Person
Phone
Fax
Address
City
State
Account Number
Personal Guarantee (Required)
Please fill out the following Personal Guarantee Form, sign and return by Fax or Email to: 225-578-3975 or [email protected]
Your Credit Application will not be considered without a Personal Guarantee.
