A.I.A. Industries, Inc.

290 E. 56th Avenue

Denver, CO 80216

303.296.9696     Fax 303.296.2146

Application For Credit
Company Name:________________________ Telephone:____________________________
Address:_____________________________ Fax Number:__________________________
City/State/Zip:_________________________ Federal ID Number:_____________________
Business Entity ( ) Proprietorship ( ) Partnership ( ) Corporation
Date Business Established:_________________ Number of Employees:___________________
 Please Provide us a copy of your current Colorado Retail Sales Tax License.
The owners and/or officers are
Name:_______________________________ Title:________________________________
Name:_______________________________ Title:________________________________
Name:_______________________________ Title:________________________________

Credit References
 Name:_______________________________ Telephone:__________________________
Address:_______________________________ Fax Number:________________________
_____________________________________

 Please Include
 Name:_______________________________ Telephone:__________________________
Address:_______________________________ Fax Number:________________________
_____________________________________

 Please Include
 Name:_______________________________ Telephone:__________________________
Address:_______________________________ Fax Number:________________________
_____________________________________

 Please Include
Unless otherwise stated, payment must be made within 30 days. A service charge of 1-1/2% will be assessed if the account is not paid within 30 days. In the event that the amount due and owing is placed with an attorney for collection, the applicant herein agrees to pay cost of court and reasonable attorney's fees.
Signature:______________________________ Date:______________________________
Title:__________________________________