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Credit Application

Thank you for your interest in Martindale Electric Company. In order to establish a credit account with our company, we ask that you complete the following application.
(All fields marked with * are required.)


If you are a subsidiary or division of another company, please state the name and address of the company.

Business Principals

Name and business address of company Principal #1 *

Name and business address of company Principal #2

Accounts Payable

Name and address of person who is responsible for handling accounts payable *


Trade References

Please furnish 3 US. Trade References

We authorize Martindale Electric Co to conduct a credit check with any or all of the above referenced companies and/or bank, for the purpose of establishing an open account with their company.

Name and Title * (Officer of Company)