Customer Credit Application Please complete the following information to request Credit to be a Ruwac Customer. Customer Credit ApplicationCompany Name* Contact Name* Title* Address* City* State* Zipcode* Telephone*Email* How long have you been in business?* Requested Credit Amount*Please enter a number from 2500 to 100000.Requested Payment Terms* Pending Ruwac SO# / Quote #* Ruwac Contact* Peer ReferencesRef #1 Company Name* Ref #1 Contact Name* Ref #1 Contact Phone #*Ref #1 Contact Email* Ref #1 Fax Ref #2 Company Name* Ref #2 Contact Name* Ref #2 Contact Phone #*Ref #2 Contact Email* Ref #2 Fax Ref #3 Company Name* Ref #3 Contact Name* Ref #3 Contact Phone #*Ref #3 Contact Email* Ref #3 Fax Additional References (Optional)Portal Website If using an online order and payment processing system. D&B Number D&B Rating Federal Tax ID or SS# NameThis field is for validation purposes and should be left unchanged.
