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.