Credit Inquiry


 Contact:                                 Date:                                               
 
 Company:                                 Phone:                                             

 Address:                                                                                                                  

 City, State, Zip:                                                                                                         

 In order that we might process a Credit Application that we have received on the above account, we would appreciate     
 your providing us with the information requested below.  Please know we will treat your response with confidentiality.


 Date Account Opened:                                    

 Average Yearly Sales:                                     

 Terms:                                    Special Terms:                                                             

 Largest Amount Owed:           When:                                            

 Total Amount Now Owed:                       Current þ Yes  þ No  Amt. Past Due:                 

 Recent Trends:  þ Promptness   þ Full Term     þ Slightly Slowþ Very Slow

 Makes Unjust Claims (Explain):                                                                                    
                                                                                                                              

 Credit   þ Honored   þ Refused (Explain):                                                                   
                                                                                                                                  
                                                        
 Check Manner of Payment:

 þ Prompt and Takes Discountsþ Slow but Collectible  þ An Excellent Account-
 þ Prompt and Satisfactory þ Slow and Unsatisfactory    Best Recommendation
 þ Prompt to         Slow  þ Accepts C.O.D.'s Promptlyþ We Do Not Recommend
 þ Makes Partial Payments  þ Collected by an Attorney   Extending Credit to
 þ Asks for Additional Timeþ In Hands of Attorney       This Account

 Special Comments:                   We will be pleased to share any information we have that will 
                                     assist you in your credit decisions.  Thank you for your
                                     assistance.
                                
                                                                                                               
                                     Name
                                                                                                               
                                     Title

     SP01 (Rev. 2/92)