K N Wattenberg Transmission LLC
Original Volume No. 1
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Effective Date: 04/01/1993, Docket: CP92-203-002, Status: Effective
Original Sheet No. 71 Original Sheet No. 71 : Effective
TRANSPORTATION SERVICES
CREDIT APPLICATION
þ K N WATTENBERG TRANSMISSION LIMITED LIABILITY COMPANY
P.O. Box 281304
Lakewood, Colorado 80228-8034
Customer Name and Address ____________________________________________________________________
_______________________________________________________________________________________________
Type of business: þ Corporation þ Partnership þ Individual
þ Other þ Specify_____________________________________________
State incorporated in________________________ Tax ID Number _____________________________________
Number of years in business under current name________________________________________________________
Has the customer changed its name in the last 5 years? þ Yes þ No
If yes, furnish prior name & address: _______________________________________________________________
______________________________________________________________________________________________________
List the three principal owners, stockholders, partners, or officers of the customer
Name _____________________ Name _____________________ Name __________________
Title _____________________ Title _____________________ Title __________________
Address _____________________ Address _____________________ Address __________________
_____________________ _____________________ __________________
Phone _____________________ Phone _____________________ Phone __________________
If a wholly owned subsidiary, name and address of parent _____________________________________________
______________________________________________________________________________________________________
Is Parent company responsible for subs debts? þ Yes þ No If yes, please furnish documentation.
Billing Address _____________________________________________________________________________________
Contact Person_________________________________________________ Phone _______________________
Amount of Credit Requested $_________________________ Net Worth $__________________________
Please Furnish One Bank Reference
Name ____________________________ Phone ___________________________________
Address ____________________________ Account Types ___________________________________
____________________________ Account Nos. ___________________________________
Contact ____________________________ ___________________________________
Please Furnish Two Business Credit References
Name _____________________________ Name ___________________________________
Address _____________________________ Address ___________________________________
_____________________________ ___________________________________
Contact _____________________________ Contact ___________________________________
Phone _____________________________ Phone ___________________________________