Call or email us after filling out this credit application. This will allow us seamless communication to try and get a partnership rolling as soon as possible!

Please enable JavaScript in your browser to complete this form.

Today's Date *

Name *

First

Last

Business Trade Name *

Address ( City, State, ZIP Code ) *

you Bank, &

Email *

Phone Number *

Fax Number

Date of Business Formation

Type of Business *

• Individual
• Partnership
• Corporation

Federal Tax Identification Number *

List of each individual or partner of the company ( name, address, phone number & title ) *

Name of Your Bank, Account # , & Branch (Along With their telephone number & bank contact name) *

Are you authorizing the release of your banking information? *

• Yes
• No

3 Listed Food Trade References (Name, Address & Phone Number) *

Do you understand that APPLICANT PROMISES TO PAY ALL PURCHASES ON OR BEFORE THE PAYMENT DUE DATE SPECIFIED ON THE RUBY FREEMAN INC INVOICES, AND IF PAYMENT IS NOT MADE ACCORDINGLY THE UNDERSIGNED AGREES TO PAY A SERVICE CHARGE OF ON BEHALF PERCENT PER MONTH ON ANY UNPAID BALANCE. IN THE EVENT OF A DEFAULT , APPLICANT AGREES TO PAY ATTORNEYS' FEE OF TWENTY ( 2 0 ) PERCENT OF THE AMOUNT DUE AND PAYABLE HERE UNDER WHEN THE ACCOUNT IS REFERRED FOR COLLECTION TO AN ATTORNEY OR COLLECTION AGENT. *

• I AGREE
• I DISAGREE

Submit