Template Series · 10
Retailer Credit Application
Credit Application
Financial Document
Template Only · Requires Review
Consult your accountant or financial advisor before extending credit terms. This template is a starting framework, credit thresholds and verification steps should match your risk tolerance.
01
Business Information
1.1. Legal Entity
Business Name: ________________
Legal Structure: ________________ (LLC / Corp / Sole Proprietor / Other)
Federal Tax ID / EIN: ________________
Years in Business: ________________
Legal Structure: ________________ (LLC / Corp / Sole Proprietor / Other)
Federal Tax ID / EIN: ________________
Years in Business: ________________
1.2. Principal Contact
Owner / Buyer Name: ________________
Title: ________________
Email: ________________ Phone: ________________
Title: ________________
Email: ________________ Phone: ________________
1.3. Billing Address
Address: ________________
City / State / ZIP: ________________
City / State / ZIP: ________________
02
Store & Channel Information
2.1. Store Type
☐ Brick & Mortar ☐ Online Only ☐ Both
Number of Physical Locations: ______
Website / Online Store URL: ________________
Number of Physical Locations: ______
Website / Online Store URL: ________________
2.2. Annual Purchase Volume
Estimated annual wholesale purchasing (all vendors): $______
Average order size (per vendor): $______
Primary product categories: ________________
Average order size (per vendor): $______
Primary product categories: ________________
03
Trade References
3.1. Trade References
Please provide three current wholesale vendors as trade references.
Reference 1:
Company: ________________ Contact: ________________ Phone: ________________
Reference 2:
Company: ________________ Contact: ________________ Phone: ________________
Reference 3:
Company: ________________ Contact: ________________ Phone: ________________
Reference 1:
Company: ________________ Contact: ________________ Phone: ________________
Reference 2:
Company: ________________ Contact: ________________ Phone: ________________
Reference 3:
Company: ________________ Contact: ________________ Phone: ________________
Guidance
Always call at least two references before extending net terms to a new account. A brief call takes 5 minutes and can prevent 90+ days of unpaid receivables.
04
Credit Terms Requested & Authorization
4.1. Terms Requested
☐ Net 30 ☐ Net 60 ☐ Net 90 ☐ Other: ______
Requested credit limit: $______
Requested credit limit: $______
4.2. Authorization
By signing below, the applicant authorizes ________________ to contact the trade references listed above and to verify business information. The applicant certifies that the information provided is accurate and agrees to the Wholesale Terms & Conditions of ________________.
Authorized. Credit Brand
Name · Title · Date
Acknowledged. Recipient
Name · Title · Date