Diamond P Enterprises, Inc.
3300 Milam Drive
P.O. Box 483
Brownwood, TX 76801-0483
325-643-5629 Phone
325-646-5653 Fax
Please print or type requested information. Any items left blank may delay processing. Items with an asterisk (*) are required. Please attach current financial statements.
Credit approval normally requires 3-5 full business days.
* Email Address
* Company Name
Trade/D.B.A. Name
Type of Business: Corporation    Partnership    Sole Proprietor
Mailing Address
  City, State           ZIP
Shipping Address
  City, State           ZIP
Federal Tax ID
Principals Owners, Home Address, Phone Number, Social Security Numbers.
Has this company or any of the owners filed bankruptcy? If so, please give the name and address under which filing was made, filing state, and case number.
Bank References  
   Bank     Telephone      Fax
   City          Zip
   Contact      Account Number
   Bank    Telephone      Fax
   City          Zip
   Contact      Account Number
Trade References  
   Name      Address
   City           Zip
   Contact    Phone    Fax
   Name      Address
   City           Zip
   Contact    Phone    Fax
We expect our monthly requirements to be $
If you are sales tax exempt, a tax exemption certificate must accompany this form. Please fax it to 325-646-5653.
(We) I have completed this application to obtain credit and certify that all statements contained therein are true and correct. (We) I understand and agree that any credit granted shall be paid promptly in accordance with credit terms, interest per month, not however to exceed the legal reate of interest, may be added to any balance not paid in accordance with said terms, invoices statements, and agreements. (We) I agree, in the event of default, to pay reasonable collections charges, attorney fees, and court cost. (We) I agree that credit inquires may be made and authorize the release of such information to you, including credit reports on principals of corporations. It is agreed that a faxed copy of the signatures on this document are as legally acceptable as the original.
Officer's/Owner's name(s)
Return to: Diamond P Enterprises, Inc.
P.O. Box 483
Brownwood, TX  76804
Fax: 325-646-5653
Email: denise@diamondpenterprises.com
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