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Request to Purchase by Credit or by Check |
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Complete Both parts and Mail to Barretts as soon as possible to Date of SaleTo: Barretts Equine Limited
P.O. Box 2010
Pomona, CA, 91769 Date:______________
SALE:______________________________________________________________
Amount of Credit Desired: $___________________________
________________________________________________________________________________
Name Drivers's License #
________________________________________________________________________________
Farm or Stable Name Home Phone #
________________________________________________________________________________
Address Business Phone #
________________________________________________________________________________
City State Zip Social Security Number
________________________________________________________________________________
Licensed Owner/ Trainer Lic. # State
________________________________________________________________________________
Trainer's Name (if applicable)
Next Part Must be Completed |
Request to Purchase by Credit or by CheckBank Information |
The Credit Applicant whose signature appears below has had
an account with this bank for _________ years.
The Average balance of this account during the past two years has been in the
range of $___________________________________________________________________
________________________________________________________________________________
Signature of Bank Officer Account No.
________________________________________________________________________________
Bank Officer (Please Print) Title
________________________________________________________________________________
Name of Bank
________________________________________________________________________________
Address City & State
_(_____)________________________________________________________________________
Telephone Number
________________________________________________________________________________
Signature of Credit Applicant
By signing this Credit Request, applicant authorizes Barretts to perform a credit
investigation
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Subscribed and sworn to before me this
___________day of____________________________________________ , 20_____
_______________________________________________________________________
Notary Public
County_________________________________________________________________
My commission expires on _______________________________________________
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