Template · Form

Credit application form for new clients — free template

A credit application collects enough information to evaluate a new client's creditworthiness before extending payment terms. It is not a credit check — it is a structured request for the client to self-disclose their financial references so you can verify them. A signed credit application also signals professionalism and puts the client on notice that you manage credit seriously.

Use it for

  • Any service business that extends net-30, net-60, or longer payment terms to new clients.
  • Businesses with average invoice sizes above $1,000 where a bad debt would meaningfully impact cash flow.
  • First-time clients without an established payment history with your business.

Do not use for

  • Existing clients with a long, positive payment history — re-applying creates unnecessary friction.
  • Consumer clients (B2C) — the relevant checks for consumers are personal credit checks, which have FCRA implications.

Variables to fill in

YOUR_BUSINESS_NAME
Your legal business name
APPLICATION_DATE
Date the application is completed
APPLICANT_LEGAL_NAME
Client's legal business name
APPLICANT_DBA
Client's trade name, if different
APPLICANT_FEIN
Federal Employer Identification Number (or SSN for sole proprietors)
APPLICANT_ADDRESS
Client's principal business address
APPLICANT_PHONE
Client's primary business phone
APPLICANT_EMAIL
Billing contact email
BANK_NAME_1
Name of client's primary bank
BANK_CONTACT_1
Bank officer name and phone (for reference call)
TRADE_REF_1_NAME
First trade reference business name
TRADE_REF_1_CONTACT
First trade reference contact person and phone
TRADE_REF_2_NAME
Second trade reference business name
TRADE_REF_2_CONTACT
Second trade reference contact person and phone
TRADE_REF_3_NAME
Third trade reference business name
TRADE_REF_3_CONTACT
Third trade reference contact person and phone
REQUESTED_CREDIT_LIMIT
The credit limit the client is requesting
AUTHORIZED_SIGNER_NAME
Name of person signing on behalf of the client
AUTHORIZED_SIGNER_TITLE
Title of authorized signer

The template

Select all and copy. Replace the {{double-brace}} placeholders with your details.

CREDIT APPLICATION
{{YOUR_BUSINESS_NAME}}
Date: {{APPLICATION_DATE}}

────────────────────────────────────────────────
APPLICANT INFORMATION
────────────────────────────────────────────────

Legal Business Name: {{APPLICANT_LEGAL_NAME}}
Trade Name (DBA): {{APPLICANT_DBA}}
Federal EIN / Tax ID: {{APPLICANT_FEIN}}
Business Address: {{APPLICANT_ADDRESS}}
Phone: {{APPLICANT_PHONE}}
Billing Contact Email: {{APPLICANT_EMAIL}}

Requested Credit Limit: ${{REQUESTED_CREDIT_LIMIT}}
Proposed Payment Terms Requested: _________________________

────────────────────────────────────────────────
BANK REFERENCE
────────────────────────────────────────────────

Bank Name: {{BANK_NAME_1}}
Contact / Officer: {{BANK_CONTACT_1}}

────────────────────────────────────────────────
TRADE REFERENCES
(Three vendors who have extended credit to your business)
────────────────────────────────────────────────

Reference 1
Business Name: {{TRADE_REF_1_NAME}}
Contact / Phone: {{TRADE_REF_1_CONTACT}}

Reference 2
Business Name: {{TRADE_REF_2_NAME}}
Contact / Phone: {{TRADE_REF_2_CONTACT}}

Reference 3
Business Name: {{TRADE_REF_3_NAME}}
Contact / Phone: {{TRADE_REF_3_CONTACT}}

────────────────────────────────────────────────
AUTHORIZATION
────────────────────────────────────────────────

By signing below, the applicant certifies that the information provided is accurate and complete, authorizes {{YOUR_BUSINESS_NAME}} to contact the references listed above, and agrees that any credit extended is subject to the payment terms established by {{YOUR_BUSINESS_NAME}}, including any applicable late payment fees.

The applicant agrees that in the event of non-payment, {{YOUR_BUSINESS_NAME}} may pursue any lawful remedy for recovery of amounts owed, including reporting to commercial credit bureaus and referral to a collections agency.

Signature: ________________________________  Date: ____________
Printed Name: {{AUTHORIZED_SIGNER_NAME}}
Title: {{AUTHORIZED_SIGNER_TITLE}}

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This template is general-purpose educational content, not legal advice. State law varies and attorney review is recommended before use. Syntharra is not your attorney.

Vetting clients before extending terms prevents most collections situations. For the invoices that do age, Syntharra handles follow-up automatically.

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