HOSIERY MILLS INDUSTRY, INC.
140 58th STREET, STE# 8 EAST, BOX 172, BROOKLYN NY 11220  
PHONE 718-567-9290 FAX 718-567-9291

                              CREDIT APPLICATION

UPON COMPLETION PLEASE FAX THIS FORM TO 718-567-9291 THEN ALLOW 24 TO 48 HOURS FOR ACCOUNT APPROVAL.

Corporate Name______________________________ DBA___________________________

Address__________________________________City______________State______zip______

Phone__________________________Fax____________________E-Mail__________________

Buyer’s Name_________________________________ A/R Contact______________________

Federal Id #_____________________________________

Annual Sales__________________________________ Yrs in Business__________________

Owner’s Name___________________________________________

Address__________________________________________SS#_________________________

Please check one: Corporation______ Partnership_____ Sole Proprietor_________

Have you already registered for an account on our website (yes or no)? 
(If you answered “Yes” above)  What E-Mail address was used to open the online account: __________________

                                                   Bank Information

Bank Name _______________________________Branch_____________________

Account Number______________________________________

Contact_________________Phone____________________Fax______________________

                                        Trade References

Company Name ________________________Contact_______________________

Address_____________________________________________________________

Phone__________________________ Fax_________________________________

Company Name_________________________ Contact______________________

Address____________________________________________________________

Phone___________________________Fax________________________________

Company Name__________________________ Contact_____________________

Address____________________________________________________________

Phone____________________________Fax_______________________________

Please answer the following questions so we can serve you better.

Would you like to be a cancel back order account?

Yes_____________ No________________

Would you like a minimum of pcs or dollar amount shipped to you?

Yes______________ No_________________ If yes #_____________

Would you like to receive a monthly statement?

Yes________________ No__________________

Do you have any special instructions, (example) po#, how you would like the merchandise packed or shipped?

Yes_________________ No__________________ If Yes Please describe below or attach instructions.

Please keep in mind you are responsible for all shipping charges.

                                             Returns

All returns must have a return authorization all other returns will be refused at your cost.

Authorizations can only come from the main office; your sales person cannot give you an ok. Phone 718-567-9290 Fax 718-567-9291.

Steps of a return:

Damages: Authorization will be sent to you.
                  Merchandise will be sent to our quality control for inspection.
                  Worn merchandise will not be accepted.

Deductions are not allowed unless you have a credit memo number, if taken your account will automatically go on credit hold.

I understand your company policy, and certify all information is true and correct.

Signature_____________________________ Title___________________ Date____________

Print________________________________________

                                    For office use only:

C/M __________________                       T/R_________________

S/M___________________                      P/C _________________

T/M___________________                      P/R _________________

UPON COMPLETION PLEASE FAX THIS FORM TO 718-567-9291 THEN ALLOW 24 TO 48 HOURS FOR ACCOUNT APPROVAL.