BANK REFERENCE INQUIRY
(COMPANY NAME)
Telephone Number:
______________________
Facsimile Number:
______________________
I, ______________________(Name),
______________(Title), of _________________
(Name of Business) acknowledge that
______________________________ wishes to obtain a bank reference on the
business checking account number _____________, and I fully authorize this
information to be given.
_______________________________
(Signature)
BANK USE ONLY ... DO NOT WRITE BELOW THIS LINE
How long has this account
been open? ___________________
Average monthly balance:
(circle one)
Low 4 figures - High 4
figures - Low 5 figures - High 5 figures - Low 6 figures
Any stop payments on checks?
None - 1 to 4 - 5 to 10 -
10 to 20 - More than 20
Any bounced checks?
None - 1 to 4 - 5 to 10 -
10 to 20 - More than 20
Please furnish any other
information that would help us to make a decision on establishing
____________________ terms with this account.
Your name: __________________________________
Bank stamp here: _____________________________
Your title: __________________________________
Comments:
____________________________________________________________
______________________________________________________________________
______________________________________________________________________
_____________________________________________________________________.
_____________________________________
(Name)
_____________________________________
(Company Name)
_____________________________________
(Company Address)
