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Back to Forms for 'Debtor and Creditor'.


BANK REFERENCE INQUIRY

BANK REFERENCE INQUIRY

(COMPANY NAME)

 

 

Telephone Number:  ______________________

 

Facsimile Number:  ______________________

 

I, ______________________(Name), ______________(Title), of _________________

(Name of Business) acknowledge that ______________________________ wishes to obtain a bank reference on the business checking account number _____________, and I fully authorize this information to be given.

 

 

  _______________________________

(Signature)

 

BANK USE ONLY ... DO NOT WRITE BELOW THIS LINE

 

How long has this account been open?  ___________________

 

Average monthly balance: (circle one)

Low 4 figures - High 4 figures - Low 5 figures - High 5 figures - Low 6 figures

 

Any stop payments on checks?

None     - 1 to 4     -   5 to 10     -     10 to 20     -     More than 20

 

Any bounced checks?

None     - 1 to 4     -  5 to 10     -     10 to 20     -     More than 20

 

Please furnish any other information that would help us to make a decision on establishing ____________________ terms with this account.

Your name:  __________________________________

Bank stamp here:  _____________________________

Your title:  __________________________________

Comments:  ____________________________________________________________

______________________________________________________________________

______________________________________________________________________

_____________________________________________________________________.

 

 

_____________________________________

(Name)

 

_____________________________________

(Company Name)

 

_____________________________________

(Company Address)

 



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