Two Technologies Rugged Customizable Handhelds, Hand Held Computers, Mobile Computers and Terminals

Two Technologies Credit Application

To apply for credit, please print the form below and fax it back to
215-441-0423 or call 215-441-5305 for assistance.

APPLICATION FOR CREDIT

Date: ___/___/___

Firm Name: __________________________________________________________

Proprietor or Partners Name: ____________________________________________

Address: ___________________________________________________________
___________________________________________________________

Phone Number: ( ) ______________ Fax Number: ( ) ________________

TRADE REFERENCES - Open Account Only

Name Address Telephone #

1.__________________________________________________________________

2.__________________________________________________________________

3.__________________________________________________________________

BANK REFERENCES

Name Address Telephone #

1.__________________________________________________________________

2.__________________________________________________________________

Dun & Bradstreet Number ______________________

I understand that Two Technologies terms are 2% 10 days Net 30 days.

Signature ___________________________________________________________

Title _______________________________________________________________

Two Technologies, inc..c. / 419 Sargon Way, Horsham, PA 19044 / 215.441.5305 / real.rugged@2T.com / www.2T.com