ALAMOS DISTRIBUTORS 1761 E. 58th Avenue, Bldg. 4 Denver, Colorado 80216 (303) 298-0705
APPLICATION FOR CREDIT

BUSINESS NAME		NATURE OF BUSINESS	HOW LONG IN BUSINESS
LEGAL NAME		BUSINESS ORGANIZATION
INDIVIDUAL	PROPRIETOR	PARTNERSHIP	CORPORATION
BUSINESS ADDRESS	CITY	STATE - ZIP	TELEPHONE

PERSON TO CONTACT REGARDING PAYMENT OF ALAMOS INVOICES
CITY	STATE	ZIP	TELEPHONE
NAMES OF OWNER(S), PARTNERS OR CORPORATE OFFICERS (indicate title):
HOME ADDRESS	TELEPHONE	SOCIAL SECURITY NUMBER	OWN RENT LEASE   HOW LONG?
HOME ADDRESS	TELEPHONE	SOCIAL SECURITY NUMBER	OWN RENT LEASE   HOW LONG?

HAVE WE EXTENDED CREDIT UNDER ANOTHER NAME? IF YES, INDICATE NAME AND DATE LAST SOLD.		YES	NO
BUSINESS BANK REFERENCE	TELEPHONE	COMMENTS
COMMERCIAL REFERENCES (LIST THREE LOCAL COMPANIES WHO HAVE EXTENDED CREDIT)
NAME	ADDRESS	TELEPHONE

APPLICANT AGREES TO COMPLY WITH THE ESTABLISHED CREDIT POLICY OF ALAMOS DISTRIBUTORS. APPLICANT AGREES TO PAY ALL COSTS AND EXPENSES INCURRED BY THE COMPANY IN CONNECTION WITH THE COLLECTION OF APPLICANT'S ACCOUNT INCLUDING REASONABLE ATTORNEY'S FEES. ALL RESPONSIBLE PERSONS MUST SIGN
(PRINT OR TYPE NAME)  OWNERS OR PRINCIPAL'S SIGNATURE	DATE
(PRINT OR TYPE NAME)  OWNERS OR PRINCIPAL'S SIGNATURE	DATE