Bring in to office or send by certified mail
FOOD WHOLESALERS
701 46th Street South
St Petersburg, FL 33711
Telephone (727) 321-2514
Fax 727-327-7427
CREDIT APPLICATION - CHECK CARD

_______________________________________  ________________________________________
 Legal Name of Firm or Individual                               Doing Business as
_______________________________________  _________________________________________
     Street address or  P.O. Box                                City, State, Zip
    Type of Ownership          Corporation           Partnership              Proprietorship 

1. ________________________  _________________________ ________________________
     Name of Principal                Home Address                        Home Phone

2. ________________________  _________________________ ________________________
     Name of Principal                Home Address                        Home Phone

If corporation:
State Incorporated ________________________
Resident Agent Info:  Name _________________________
                                 Address _____________________________________________________
                     Telephone __________________________________
Kind of Business _______________________________
How long in Business under present owner? __________________________
Building    Own      Lease  
Name of Bank ________________________________ Account Officer ______________________
Address ____________________________________ Account Number ______________________
City and State ________________   ______              Phone Number _______________________
Information obtained from ______________________ Position _____________________________
Individual Personal Guaranty
I / we personally guarantee to Food Wholesalers, Its Successors or assigns, full payment of all indebtedness
of:   
_____________________________________    _____________________________________
     Name                                                Corporate Name
This guarantee will remain in full force and effect, until written notice of its termination is received by Food
Wholesalers. Notice shall be sent Certified Mail: Return Receipt.
It is further agreed that all reasonable costs, associated with the collection of this amount shall be borne by
purchaser.

_______________________________________  ______________________________________
Guarantor                                                 Date       Guarantor                                                  Date
_______________________________________  ______________________________________
Home Address                                                Home Address
Driver License # _________________________   Driver License # ___________________________

Must be completely fill out or credit will not be extended. Driver license # required for Checks.

Suppliers                                Address                        Telephone
________________________      ________________________    ______________________
________________________     _________________________   ______________________
________________________      _________________________  ______________________