GROWERS SUPPLY CREDIT APPLICATION

GROWERS SUPPLY

Farm Tools and Supplies

P.O. Box 3537

Turlock, CA 95381-3537

Phone (888) 300-7658

APPLICATION FOR CREDIT

Business Name * Resale #
DBA Federal Tax ID # *
Mailing Address
Shipping Address
Shipping Address(#)
Main Contact
Accounts Payable Contact

OWNERSHIP:

PRINCIPAL:

CREDIT REFERENCES

Company Phone Address

BANK REFERENCE