(****Print out and return by mail or fax for processing****)
CREDIT APPLICATION
Forbes Distributing Company, Inc P.O. Box 1478 Birmingham, AL  35201
Phone (205) 251-4104  FAX (205) 251-4115  WATS 1-800-292-6004

BUSINESS INFORMATION

DESCRIPTION OF BUSINESS
Firm Name    
SSN / EIN    
Address    
City, State,Zip     
Phone #
Fax #
No. of Employees Credit Requested Years in Business
Type of Business
Business Structure

Corporation ___

Partnership ___

 Proprietorship ___

Division/Subsidiary ___  
Name of Parent Company___________________

Company Principals responsible for Business Transactions
Name: Title: Phone:
Name: Title: Phone:
Name: Title: Phone:

Trade References
Please furnish a complete mailing address
Company Name: __________________________________________________ 
_______________________________________________________________ 
_______________________________________________________________
_______________________________________________________________
Company Name: __________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
Company Name: __________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________		 Phone #: __________________
Fax #:      __________________


Phone #: __________________
Fax #:      __________________

Phone #: __________________
Fax #:      __________________

Ala. Sales Tax # ______________________  Or Exempt # _________________
City Sales Tax # ______________________ County Tax # _________________
A copy of your tax certificate(s) is required with this application

Confirmation of information accuracy and release of authority to verify

The above information is furnished for the purpose of securing an extension of credit for commercial business use only, from FORBES DISTRIBUTING COMPANY, INC. The applicant authorizes FORBES DISTRIBUTING COMPANY to obtain a written or oral credit report from any credit reporting agency and further authorizes any bank and/or commercial business with whom the applicant is doing or has done business to givce any an all necessary information which will assist FORBES DISTRIBUTING COMPANY in its credit investigation. The applicant further authorizes FORBES DISTRIBUTING COMPANY to reinvestigate the applicant's credit status from time to time and should FORBES DISTRIBUTING COMPANY, upon such investigation, deem it necessary, to limit or terminate the credit of the applicant.
The applicant hereby agrres to pay a service charge of 1½% per month on any amounts not paid within FORBES DISTRIBUTING COMPANY's credit terms (credit terms are printed on all invoices and statements), and hereby expressly waives all rights of exemption under the Constitution and Laws of the State of Alabama, and any other state, as to personal property, and agrees to pay costs of collection, including a reasonable attorney's fee.

Signature___________________________      Title__________________   Date_______________

Policy Statement: Initial order from new accounts will not be processed
unless accompanied by the above requested information.





CREDIT INQUIRY

TO:

 FROM:

BANK NAME & ADDRESS:
___________________________________________
___________________________________________
___________________________________________

 APPLICANT NAME & ADDRESS:
___________________________________________
___________________________________________
___________________________________________
Gentlemen:
I AM APPLYING TO 'FORBES DISTRIBUTING COMPANY' FOR A LINE OF CREDIT AND I HAVE GIVEN
YOU AS A CREDIT REFERENCE.  PLEASE GIVE THEM YOUR EXPERIENCE AND OPINION AT THE BOTTOM
OF THIS LETTER AND RETURN IT TO THE ADDRESS BELOW.  I WOULD APPRECIATE IT IF YOU COULD RESPOND AS SOON AS POSSIBLE.

NATURALLY, FORBES DISTRIBUTING COMPANY WILL HOLD YOUR RESPONSE IN STRICTEST
CONFIDENCE, AND WILL BE GLAD TO RECIPROCATE AT ANY TIME.

VERY TRULY YOURS,
APPLICANT SIGNATURE:                                                                                    BANK ACCOUNT #:

__________________________________                                 ___________________________

INDICATE EXPERIENCE BELOW AND RETURN TO:

FORBES DISTRIBUTING COMPANY    P.O. BOX 1478    BIRMINGHAM, AL. 35201
HAD ACCOUNT SINCE _____________________              AVERAGE BALANCE       $________________
DEPOSITORY RELATIONSHIP SATISFACTORY:      YES _____     NO _____

HAVE ANY CHECKS BEEN RETURNED DURING THE LAST YEAR BECAUSE OF INSUFFICIENT FUNDS?
                    YES _______      NO _______
DETAILS:

SECURED LOANS:        HIGHEST AMT?    $___________      AMT OWING   $_________

UNSECURED LOANS:   HIGHEST AMT?  $____________   AMT OWING    $__________

    LOAN PAYMENTS:

EXCELLENT   _______                 GOOD   ________                      SLOW BUT SATISFACTORY  ______

UNSATISFACTORY  _______    MONTHS SLOW   _______
COMMENTS:___________________________________________________________________________________
______________________________________________________________________________________________
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