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Smoky Mountain Sand & Gravel
245 Brookdale Rd, Maryville, TN 37804 · (865) 999-0857 · hello@smokymountainsg.com
Account & Credit Application
1. Business Information
Business (DBA) Name
Legal Business Name (if different)
Business Type (LLC / Corp / Sole Prop / Partnership)
Federal Tax ID (EIN)
Billing Street Address
City
State
ZIP
Years in Business
Years at Current Address
Est. Loads / Week
2. Contacts
Primary Contact
Full Name
Phone
Email
Accounts Payable Contact (if different)
Full Name
Phone
Email
3. Requested Terms
Cash / Pay Per Load (no credit review needed)
Or request credit terms:
Net 15Net 30Net 45Net 60COD
Requested Credit Limit ($)
4. Trade References (required for credit terms)
Reference 1
Company
Phone
Account #
Reference 2
Company
Phone
Account #
Reference 3
Company
Phone
Account #
5. Bank Reference (required for credit terms)
Bank Name
Officer / Contact
Phone
6. Annual Revenue
Under $250K$250K – $1M$1M – $5M$5M – $25MOver $25M
7. Certification & Signature
I certify that the information above is accurate to the best of my knowledge and authorize Smoky Mountain Sand & Gravel to verify the trade and bank references listed. I understand that credit terms and limits are subject to review and may be denied, and that SMSG can revoke or modify terms at its discretion.
Owner / Authorized Signer Name
Title
Signature
Date