Dependo Rent-All INC.
1620 Lafayette Rd. FT. Oglethorpe, GA. 30742
Phone (706) 866-6845 or FAX (706) 866-3466 (not dedicated)

Application for Credit

Name of Firm:
Address:				City:
State:		Zip:		Phone:

Number of years in Business:		Line of Work:
Partnership:	Sole Proprietorship:	Corporation:
SS#:			Or Fed ID#:

Principal Members of Firm
Name:			Title:			Home Phone:
Name:			Title:			Home Phone:

Business References
#1 Name:					Phone:
#2 Name:					Phone:
#3 Name:					Phone:
#4 Name:					Phone:

Name of Rental Store that you have an account with now:

Is a Purchase Order Required ?	Yes:	No:

List of persons authorized to sign:



Customer agrees to pay all bills net on receipt and agrees to be 
responsible for all collection repossession, attorney's and court 
costs incurred in connection with the collection of accounts owned.

Signed by:       		Officer:		Date:

(Must be signed by officer)