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Agreement & Application for Credit
3300 Brother Blvd., Bartlett, TN 38133 • 901-382-4300 Fax 901-592-5756 • Email: dlcredit@kele.com

(* denotes required fields)

General Company Information
Company Legal Name*:   Phone*:    
Billing Address*:    
City*:  
State/Province*:      
Country*:     Zip/Postal Code*:  
Fax:     Years Established*:    
E-invoicing*:    
Business Type*:     Anticipated monthly purchases*: $    
Federal ID Number*:             D&B Number:  
SIC Code:  
 
AP Contact
First Name*:     Phone*:    
Last Name*:    
Email*:      
 

Authorized Purchasing Agent
First Name*:     Phone*:    
Last Name*:    
Email*:      
 
Owners/Principals
First Name*:     Phone*:    
Last Name*:         Title*:  
% of Ownership*:        SSN*:    
Email*:      
 
First Name:         Phone:  
Last Name:             Title:
% of Ownership:            SSN:  
Email:    
 
Agreement



This credit application is given to secure a credit line with Kele, Inc. on Net 30 terms. Your application will be forwarded to our Credit Department for further analysis in order to establish a permanent credit line. I certify that the information contained herein is correct and true. The undersigned officer hereby authorizes Kele, Inc. permission to obtain credit information which will be kept strictly confidential.

Please forward an original signed application along with your tax exempt certificate to dlcredit@kele.com or fax to 901-592-5756