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C.H. Brown Company Credit Application


You can print or download our credit application HERE.

Credit Application

Use N/A for Blank fields

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Section A

Applicant Information


IndividualDBAS-CorpPartnershipCorporationProprietorship





MarriedUnmarried

YesNo




































Section B

Co-Applicant/Co-Owner Information












YesNo

Section C

Operation Information


YesNo

ReplacementExpansion






Section D

Credit References































Section E

Referral



Section F

Equipment















Section G

Hauling and Work Sources - List All





















Section H

Personal Information














Own Home OutrightLiving with RelativesBuying a HomeLeasing/Renting





YesNo

YesNo

YesNo

NOTICE OF JOINT INTENT


We intend to apply for joint credit (Signature required below).I am applying for credit in my own name only, and am relying on my income/assets in my name only for repayment of this loan.


















NOTICE

The undersigned acknowledge(s) that this signed application, submitted for the purpose of obtaining credit from CH Brown Co., is true and correct in every detail and fairly shows my/our financial condition at the time indicated. I/We will give prompt written notice of any subsequent substantial change in such financial condition occurring before discharge of this obligation to you. I/We understand that you will retain this application whether or not you approve the credit in connection with which is submitted. You are authorized to check any credit or employment history or any other information herein.

Any willful misrepresentation on this statement could result in a fine and/or imprisonment under provisions of the U.S. criminal code.











C.H. BROWN CO

20 W Frontage Road Wheatland, WY 82201 Tel: 307-322-2545 Fax: 307-322-9192

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