Clean Cutter Tiller Blades Credit Application
Thank you for your interest in a line of credit. Please provide the following information and fax to (909) 884-5954, or mail to: 169 So. Sierra Way, San Bernardino, CA 92408.

(1)	Your Information:

                       ____________________________________________________________
NAME
		
		____________________________________________________________
		ADDRESS (CITY, STATE, ZIP)
	
		____________________________________________________________
		PHONE NUMBER AND CONTACT

(2)	Business References:

1)	____________________________________________________________
NAME
		
		____________________________________________________________
		ADDRESS (CITY, STATE, ZIP)
	
		____________________________________________________________
		PHONE NUMBER AND CONTACT

2)	____________________________________________________________
NAME

____________________________________________________________
ADRESS (CITY, STATE. ZIP)

____________________________________________________________
PHONE NUMBER AND CONTACT

(3) Banking Reference:	   YOUR ACCOUNT NUMBER_____________________

____________________________________________________________
NAME

		____________________________________________________________
		ADDRESS (CITY, STATE, ZIP)

		____________________________________________________________
		PHONE NUMBER AND CONTACT

If you have any questions concerning this credit information, please give us a call at 
(800) 345-2335 or (909) 889-4084.