Credit Application (US) Great Northern Products Ltd. Credit Application Please complete the credit form in its entirety and press submit. Thank you General Information Credit Limit Requested Corporate (Legal) Name * Trade Name (DBA) Billing Address Select StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific Shipping Address Same as BillingDifferent from Billing Billing Address Select StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific Phone * Fax Email * Business Type CorporationPartnershipSole Proprietor Date Started Tax Information Federal Tax IDSocial Security No. Please select either option for tax purposes President Treasurer Accounts Payable Contact Bank Information Bank Name Bank Address Select StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific Bank Phone Bank Fax Bank Contact Checking Account No. Borrowing Account No. Trade References (4) (Seafood Preferred) Trade References Name Contact Phone Fax Do you Release a Financial Statement? YesNo Agreement 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 *