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1Application
2Guaranty Agreement
Full Legal Name
Billing Address
Accounts Payable Contact
Shipping Address
If Yes, a signed Sales & Use Certificate of Exemption must be attached or emailed at the time of submission. Or Gate Card no. listed below.
Bulloch Fertilizer Co., Inc. utilizes a credit reporting service to process all applications for credit. You MUST provide either a Social Security Number or a Federal ID Number in order for this application to be considered.
If applying for an individual account
All information listed above is kept in strict confidence at our accounting office located at 205 West Main Street, Statesboro, GA.
By Signing below as applicant, you authorize Bulloch Fertilizer Co., Inc. to investigate your credit history to the extent allowed by law.
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