Credit Reference Request

CREDITREFERENCEREQUEST
Date: ________________
To:[name & address of credit reference]
Re:[name of person seeking a credit reference]
Dear Madam/Sir:
The above referenced company has applied for credit with our company and has listed you as a
credit reference. To assist us in making our credit decision, please provide us with the below
requested information:
High credit limit: _____________________
Present balance: _____________________
Payment history: _____________________
Number of payments more than 30 days late: ______________
Length of time account open: ________________
Other information that we should consider:
_____________________________________________________________________________
_____________________________________________________________________________
Any information received from you will be held confidential. Please return the completed form
via e-mail to tliberto@synteccorp.com, or fax 410-327-1078, or mail to the address above.
Sincerely,
Tim Liberto
Corporate Credit Manager
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