Call Us Today: (812) 332-2553
Serving Bloomington, Bedford, Bloomfield, Martinsville and Columbus

Credit Application

Southside Rental

1717 S. Walnut Street

Bloomington, IN 47401

CREDIT APPLICATION

Firm Name:

Contact Person:

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Type of Business:

Year Business Opened:

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Federal ID # or SS #:

Principals Name:

Bank References

Bank Name:

Account #:

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Date Account Opened:

Trade References

Firm Name:

Phone:

Firm Name:

Phone:

Firm Name:

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The undersigned hereby agrees that should a credit account be opened, and in event of default in the payment of any amout due, and if such account is submitted to a collection authority, to pay an additional charge equal to the cost of collection including court cost. The undersigned individual who is either a principal of the credit applicant or a sole proprietorship of the credit applicant, recognizing that his/her individual credit history of the applicant, hereby consents to and authorized the use of a consumer credit report on the undersigned by the above name business credit grantor, from time to time as may be needed, in the credit evaluation process.

I agree to the above statement.

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Southside Rental

Bloomington, Bedford, Bloomfield, Martinsville and Columbus
1717 S Walnut St
Bloomington, IN 47401
Phone: (812) 332-2553

Regular Store Hours

Mon - Sat: 8:00 am - 5:00 pm
Sunday: Closed
Southside Rental Bloomington - Contact Us Bottom


For reservations please call:

(812) 332-2553