Company Name:

Address:

D & B Rating: Contact Person:



Bank Reference
Bank Name:

A/C#: Tel#: Fax#:

Contact Person:


NOTE: Please fax back to us together with this form a letter authorizing your bank to release credit information to ITP Corporation. Thank you.


Trade Reference 1:
Company Name:

Address:

Attn: Tel: Fax:


Trade Reference 2:
Company Name:

Address:

Attn: Tel: Fax:


Trade Reference 3:
Company Name:

Address:

Attn: Tel: Fax: