CREDIT APPLICATION Apply For Credit With EDM Fields marked with * are required Company Name* Years In Business Owners Name* UBI Number* D&B Number* Billing Name* Billing Address* City* State/Province* Zip/Postal Code* Contact Email* Contact Phone* Shipping Name* Shipping Address* City* State/Province* Zip/Postal Code* Contact Email (Shipping)* Contact Phone (Shipping)* Authorizing Party* Title* Date*