Credit Information Request
Sunday, January 17, 2021
[To] Company Name
First, Last Name
City, State 00000
RE: Credit Reference for [APPLICANT NAME]
Our company, [BUSINESS NAME], has received a request for credit terms from [APPLICANT NAME] whom has
provided you as a credit reference. Please answer the following questions to assist us in making a decision regarding
the application for credit.
______________ How long has [APPLICANT NAME] had an open account?
______________ Credit Limit
______________ Current Balance
______________ High Balance
______________ Number of Late Payment
Thank you for taking the time to answer the above questions. All information provided by you above will be held
confidential. Please return this form to [BUSINESS NAME] before [DATE] within the enclosed stamped envelope.