Credit Reference Inquiry

Thank you for taking the time complete this inquiry. Your customer listed below has listed you as a credit reference.

Business Name

Business Phone

Customer #:

Date Account Opened

Payment Terms

Choose the option closest to the customer's actual terms

Current Balance

Credit Limit

High Credit

Amount Past Due

Days Past Due

Last Invoice Date

Payment History

Always on time

Occasionally late (1-2 times per year)

Frequently late (3-6 times per year)

Consistently late (more than 6 times per year)

Has missed payments

Your Business Name

Contact

Reference Phone Number

Reference Email

Any information you are able to provide for us will be held in the strictest confidence. Thank you for your cooperation. Please return via email to ar@rockymountainspice.com.