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Name of Owners / Partners /Officers:

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CREDIT REFERENCES: (Please submit 3.)

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The undersigned agrees to pay all obligations extended as a result of this application for credit and it is hereby specially agreed that if such account is placed in the hands of an attorney or agency for collection or is collected by suit, or other probate proceedings, we promise to pay the principal, collection fees, and interest due plus reasonable attorney's fees together with all costs of court.