Credit Application

If you are a distributor and would like to purchase items from us for resale, we are happy to consider opening a credit line for your company. The information entered on this form will be encrypted during transmission to protect the identities, ensure the privacy, and secure the data of all parties involved.

Credit Department
Phone: 817-926-8828
Fax: 817-429-5602

Company Information
Company Name: Year Est.
Street Address:
Phone:
Fax:
City: State: Zip:
E-mail:
Contact Name: Title:
Type of Business: Credit Limit Requested:
Ownership: Corporation Partnership Proprietership Other
Sales Tax#: Federal Tax#:
Principals/Company Officers
1. Name/Title:
Address:
City:
State:
Zip:

2. Name/Title:
Address:
City:
State:
Zip:

3. Name/Title:
Address:
City:
State:
Zip:
Trade References
1. Address:
City: State: Zip: Phone:

2. Address:
City: State: Zip: Phone:

3. Address:
City: State: Zip: Phone:

4. Address:
City: State: Zip: Phone:

Download Blank Form: Texas Sales and Use Tax Resale Certificate

Upload Texas Sales and Use Tax Resale Certificate:
(or fax to 817-429-5602)

The undersigned confirms that the above information is true and accurate and herby authorizes Franklin Electric Supply to obtain credit and/or financial information from the bank and references listed above. If given open terms of credit with Franklin Electric Supply, the undersigned promises to pay for all purchases in accordance witht those terms. If a corporation, the undersigned personally guarantees payment of all invoices. If at any time the undersigned is unable to meet its financial obligations with Franklin Electric Supply, the undersigned agrees to pay for legal, court or any other fees necessary to collect unpaid invoices. All sums are due and payable in Tarrant County, Texas.

Name: Date:
Signature (initials): Title: