General Information                          Credit Limit Requested

Corporate (Legal) Name

Trade Name (DBA)

Billing Address

Shipping Address Same     or Other 

Phone #   Fax #     Email 

Business Type: Corporation  Partnership  Sole Prop

Date Started       Federal Tax ID#/Or SS# 

President   Treasurer 

Accounts Payable Contact  

Bank Information

Bank Name  

Bank Address  

Phone #    Fax #    Contact  

Checking Acct#   Borrowing Account #  

Trade References (4) ( Seafood Preferred)

Name Contact   

Phone # Fax #

Name Contact   

Phone # Fax #

Name Contact   

Phone # Fax #

Name Contact   

Phone # Fax #

Do you release a Financial Statement:  Yes  No

To induce Great Northern Products Ltd. ("Great Northern Products") to extend credit to the above customer applicant ("Applicant"), the undersigned ("Guarantor"), hereby unconditionally guarantees the payment of all indebtedness of Applicant to Great Northern Products. Guarantor agrees to pay any and all costs and expenses, including service charges, interest and/or reasonable attorney's fees that may be incurred by Great Northern Products in connection with this Guaranty or in the collection of any indebtedness or liabilities hereby guaranteed. Guarantor’s obligation hereunder shall be joint and several with the obligations of any other guarantor, if any, of the indebtedness and liabilities of Applicant to Great Northern Products.

Guarantor also represents that the above information is true and correct and acknowledges that any false information stated on this Customer application or on any other document relied upon by Great Northern Products in its decision to extend credit to Applicant may result in denial of credit and/or further action including, but not limited to, revocation of credit.

I hereby authorize the above listed bank and trade sources to release pertinent information to Great Northern Products, Ltd. for evaluation of credit limits.

Signed: Date: