Credit Application:
Name:
Company Name:
Accounting Contact, Name/Title:
Billing address:
City;
State:
Zip:
Phone Number:
Fax Number:
E-Mail:
Federal ID No:
Resale No:
P.O. Required:	Yes No

References:
Name of Bank:
Phone:
Fax:
Account No.
D & B No:

Trade References are required for your application to be processed:
(1) Company:
Phone:
Fax:
Account No:
D & B No:

Trade References are required for your application to be processed:
(2) Company:
Phone:
Fax:
Account No:
D & B No:

Trade References are required for your application to be processed:
(3) Company:
Phone:
Fax:
Account No:
D & B No:

Optional:

Name other suppliers that you represent:
Stretch Film:
Food Film:
Foil:
What Western Plastics products are you most interested in?
Do you have other branches:	Yes No
If yes, please list:

Calhoun, GA	Temecula, CA	Mississauga, CAN	International
(800) 752-4106	(800) 442-9727	(800) 957-8886	(951) 695 1983

Disclaimer: The information and data in this report has been obtained from sources considered reliable. Their accuracy or completeness is not guaranteed and the giving of the same is not to be deemed as an offer or solicitation. Any decision to purchase or sell as a result of the opinions expressed in this report will be the full responsibility of the person authorizing such transaction.