"Credit Application Form"

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Appendix “A”
Credit Application Form
CREDIT APPLICATION
GENERAL CREDIT INFORMATION FORM
Customer Information
Customer Name: _____________________________________________________________
Street Address: _______________________________________________________________
City: ____________________________________________ State: ____________ Zip Code: ___________
Contact Person: __________________________ Phone: _____________ E-mail: ____________________
NERC Acronym:________________ SIC Code:
Dun & Bradstreet no.:______________
Attach Financial Statements as described in Section 3.1.1.1 of the SPP Credit Policy or give web
address where they may be obtained:
$
Credit Customers anticipated peak monthly transmission activity:
$
Credit Customers anticipated peak weekly market activity:
Bank Reference
Bank Name: ______________________________________ Account No(s): _________________________
Street Address: __________________________________________________________________________
City: ____________________________________________ State: ____________
Zip Code: __________
Contact Person: ____________________________ Phone: _____________ E-mail: __________________
SIGNIFICANT COMMERCIAL REFERENCES
1. Company Name: _____________________________________________________________________
Contact: ____________________________ Phone: _____________
E-mail: ______________________
Contract Date: __________________________
Contract Amount: ______________________________
2. Company Name:
________________________________________________________________________
Contact: ____________________________ Phone: _____________
E-mail: _______________________
Contract Date: __________________________
Contract Amount: ____________________________
Appendix “A”
Credit Application Form
CREDIT APPLICATION
GENERAL CREDIT INFORMATION FORM
Customer Information
Customer Name: _____________________________________________________________
Street Address: _______________________________________________________________
City: ____________________________________________ State: ____________ Zip Code: ___________
Contact Person: __________________________ Phone: _____________ E-mail: ____________________
NERC Acronym:________________ SIC Code:
Dun & Bradstreet no.:______________
Attach Financial Statements as described in Section 3.1.1.1 of the SPP Credit Policy or give web
address where they may be obtained:
$
Credit Customers anticipated peak monthly transmission activity:
$
Credit Customers anticipated peak weekly market activity:
Bank Reference
Bank Name: ______________________________________ Account No(s): _________________________
Street Address: __________________________________________________________________________
City: ____________________________________________ State: ____________
Zip Code: __________
Contact Person: ____________________________ Phone: _____________ E-mail: __________________
SIGNIFICANT COMMERCIAL REFERENCES
1. Company Name: _____________________________________________________________________
Contact: ____________________________ Phone: _____________
E-mail: ______________________
Contract Date: __________________________
Contract Amount: ______________________________
2. Company Name:
________________________________________________________________________
Contact: ____________________________ Phone: _____________
E-mail: _______________________
Contract Date: __________________________
Contract Amount: ____________________________
3. Company Name:
________________________________________________________________________
Contact: ____________________________ Phone: _____________
E-mail: _______________________
Contract Date: __________________________
Contract Amount: ____________________________
Identify or describe any loss contingencies that require disclosure under Section 3.1.1.3 of the SPP
Credit Policy. Attach documents as necessary:
Identify all Affiliates that are Credit Customers. Give NERC Acronym, SIC Code, and Dun and
Bradstreet number for each:
Credit Support
Intended form(s) of credit support if know at this time:
a)
Cash (See Section 7.1.2 and Appendix B)
b)
Irrevocable Letter of Credit (See Section 7.1.3 and Appendices B and C)
c)
Guaranty (See Section 3.1.3, Article Six, and Appendix D)
Not-For-Profit Companies, as defined in Section 4.2.3, should also answer the Additional Not-For-
Profit Questions to help SPP have a better understanding of your organization. If your organization
will not be considered a Not-For-Profit company it is not necessary that you answer the additional
questions.
Authorized Signature: ____________________________________________
Date: ________________
Print Name: _____________________________________________
Title: ___________________________________________________
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