CREDIT1
                                                                                                                  CREDIT ACCOUNT APPLICATION
                                                                                                                   DATE   ________________________


                                                            R  &  I  SHOP
                                               HEAVY DUTY & LIGHT TRUCKS
                                               2695 Kee Moore Drive
                                               Chester,  SC  29706
                                                Phone: (803) 789-5635
                                                Fax:     (803) 789-5101

BUSINESS TYPE:  __ Sole Proprietorship  __Partnership  __Corporation – In State of ____  
Number of years in business___________________  D and B Number ____________________
COMPANY NAME ____________________________________________________________
ADDRESS _____________________________________________________________________
CITY ______________________________ STATE ______________________ ZIP __________

NAME AND ADDRESS OF INDIVIDUALS OR PARTNERS – NAME/TITLE/PHONE NUMBER OF CORPORATE OFFICERS

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NAME OF  PERSON TO CONTACT REGARDING PURCHASE ORDERS AND INVOICE PAYMENT, TITLE, ADDRESS AND PHONE NUMBER

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BANK REFERENCE                                           BANK ACCOUNT NUMBER, CONTACT, TITLE AND PHONE NUMBER

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TRADE REFERENCES: COMPANY NAME, ADDRESS, CONTACT AND TITLE, AND PHONE NUMBER

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THE ABOVE INFORMANTION IS HEREWITH SUBMITTED FOR           SIGNED   ___________________________________________
THE PURPOSE OF OPENING AN ACCOUNT AND I DO HEREBY
CERTIFY THIS INFORMATION TO BE TRUE.                                       TITLE ______________________________________________

                                                                            DATE _______________________________________________

NOTES ON ACCOUNT APPLICATION  _____  APPROVED   _____DISAPPROVED – REASONS _______________________________

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