340 4th Street
Ewing, NJ 08638-2750

800-400-7154

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Dealer Credit Application

FORM VOID UNLESS COMPLETE INFORMATION IS SUPPLIED





Bank References
We authorize you to release information concerning the noted account(s) with your bank/company to Hough Petroleum for the purpose of credit verification.

The undersigned individual(s) who is either a principal of the credit applicant, or a sole propriertorship of the credit applicant, recognizing that his or her individual credit history may be a factor in the evaluation of the credit history of the applicant, hereby consents to and authorizes the use of a consumer credit report on the undersigned by the above named business credit grantor, from time to time as may be needed, in the credit evaluation process.
Credit References




Customer Survey - Please Complete
Personal Financial Statement

ASSETS
LIABILITIES