Attention: Credit Department
1001 Louisiana
Houston, TX 77002
Return to: Sharon Kimball Phone: (713) 420-2062 Fax: (713) 420-1924
Ted Chavez Phone: (713) 420-3068 Fax: (713) 420-1924
Gary Hammett Phone: (713) 420-4360 Fax: (713) 420-1924
Date:
CREDIT INFORMATION
Instructions: Complete the following information, attach your most recent copies of the following items (as applicable), and return to the above address as soon as possible:
· Annual Report · Audited Financials · Form 10K · Form 10Q
Company Information
Name:
Attention:
Address:
Accounts Payable Contact, Title, & Phone:
Marketing Contact, Title, & Phone:
Classification (check one)
Private-Corporation Public-Corporation S-Corporation Governmental
General-Partnership Limited-Partnership Sole Proprietor Nonprofit
Fiscal Year End: D&B No:
Description of Business Activity:
Officers and Controlling Shareholders
(Complete only if a Nonpublic Company)
Name Title Ownership
Parent Company
D&B No: If necessary, will parent guarantee payment? Yes No
CREDIT INFORMATION (Continued)
Trade References
Company/Address Phone/Contact Person
1. Company: Phone:
Address: Fax No:
City, State, Zip: Contact Person:
2. Company: Phone:
3. Company: Phone:
4. Company: Phone:
Bank References
Contact:
Phone: Fax:
1. We hereby authorize El Paso Corporation and/or its subsidiaries to obtain or exchange any information that may be required relative to this Application from any source, including Applicant's financial institutions, trade suppliers, and credit information databases. Applicant authorizes each source to provide such information.
2. The undersigned Applicant certifies that the information supplied on this Credit Application ("Application") is accurate and correct as of the date of this Application.
By:
Applicant's Signature
Title: