APPLICATION FOR CREDIT  
 (Best if Viewed with Microsoft Internet Explorer)
 to
UNITED MINERAL & CHEMICAL CORPORATION
1100 Valley Brook Avenue, Lyndhurst, NJ 07071
Tel: 201-507-3300  Fax: 201-507-1506

 

We hereby apply for credit and certify that the following information is correct. It is our understanding that the information will be held in strict confidence.

 
                           Name: 
Company:
Telephone:
Fax: 
Address:
City:
Zip: 
Subsidiary of: 
Type of Ownership:  Corporation    Partner     Parent
 
Principal Owners:
Name of Bank:
Bank Telephone:
Bank Fax: 
Account Officer: 
Account Number:
Bank Address:
Zip:
 
References (Firms Extending Credibility) 
 
1) Company:  
   Telephone: 
  Fax: 
Address: 
     City: 
 Zip: 
  Contact:
 
 2) Company:  
Telephone: 
   Fax:
Address: 
  City: 
 Zip: 
Contact: 
 
    3) Company:
  Telephone: 
    Fax:  
 Address: 
       City: 
 Zip: 
   Contact:  
 
Important: For Prompt Attention Latest Financial Statements must be Sent to us with this Application
We Understand that your Terms are and agree to meet these terms if extended
  Contact:
  
Date/ Month/ Year:
  Name:
  Title: