Credit Application

If you are new Paradigm customer and would like to be billed for products or services, please take a moment to fill out our Credit Application and Texas Resale Certificate form.

*Company Name:

*Phone Number:

*Billing Address:

*Billing City:

*Billing State:

*Billing Zip Code:

*Shipping Address:

*Shipping City:

*Shipping State:

*Shipping Zip Code:

*Email Address:

*Type of Business:

*Amount of Credit Requesting:

*Do you have or had any accounts with us (blank for No / Provide account name for YES):

Name or owner of principals:

*Principal #1 Name:

*Principal #1 Title/Position:

*Principal #2 Name:

*Principal #2 Title/Position:

Bank Reference:

*Bank Name:

*Bank Address:

*Lending / Account Officer Name:

*Loan Account #:

*Commercial Account #:

*Personal Account #:

Commercial Trade Reference #1:

*Company Name:

*Credit Manager's Name:

*Phone:

*Fax:

Commercial Trade Reference #2:

*Company Name:

*Credit Manager's Name:

*Phone:

*Fax:

Commercial Trade Reference #3:

*Company Name:

*Credit Manager's Name:

*Phone:

*Fax:

Additional Information:

Please fax a copy of your tax certificate to: 817-831-9407. A tax certificate is required to complete your application!

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Credit Application