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Retailer Credit Application

P23-EDU Brand Intelligence Library
Retailer Credit Application
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P23-EDU Template Series · 10

Retailer Credit Application

Credit Application

Financial Document
From________________
To________________
Date________________
Version1.0
01
Business Information
1.1 — Legal Entity
Business Name: ________________

Legal Structure: ________________ (LLC / Corp / Sole Proprietor / Other)

Federal Tax ID / EIN: ________________

Years in Business: ________________
1.2 — Principal Contact
Owner / Buyer Name: ________________

Title: ________________

Email: ________________    Phone: ________________
1.3 — Billing Address
Address: ________________

City / State / ZIP: ________________
02
Store & Channel Information
2.1 — Store Type
☐ Brick & Mortar    ☐ Online Only    ☐ Both

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: ________________
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: ________________
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: $______
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
Net Terms Cost Calculator → Account Retention & LTV Calculator → Cash Flow Gap Calculator →