<p> JOHN F. KILROY CO., INC. Customs Brokers & Int’l Freight Forwarders One Cross Island Plaza, Suite 203E ~ Rosedale, NY 11422 ~ U.S.A. Tel: 718-656-7818 ~ FMC 000114NF ~ Fax: 718-656-8888 Email: [email protected] Web Site: www.jfkilroy.com</p><p>Credit Application</p><p>Company ______</p><p>Address ______Federal ID#______</p><p>City ______State ______Zip ______</p><p>Tel ______Email ______</p><p>Name(s) of Officers / Partners / Principals (Include Title)</p><p>1. ______2. ______</p><p>3. ______4. ______</p><p>Corporation ______Partnership ______Sole Proprietor ______Year Established ______</p><p>Estimated Annual Sales ______Controller ______</p><p>Credit Reference</p><p>Bank ______Account No. ______</p><p>Address ______State ______Zip ______</p><p>Tel ______Account Officer ______</p><p>Trade References</p><p>Company ______Address ______</p><p>Tel ______Email ______Contact______</p><p>Company ______Address ______</p><p>Tel ______Email ______Contact______</p><p>Company ______Address ______</p><p>Tel ______Email ______Contact______</p><p>The above information is required in order to establish an open account with your firm, with the understanding, all charges will be paid upon receipt of our invoice. Any information contained herein will be considered confidential by JOHN F. KILROY CO., INC. Date ______Signature ______Title______</p><p>Dependable Service Since 1932</p>