WILLIAMS LAWN SEED, INC.
					CUSTOMER CREDIT APPLICATION
					P.O. BOX 112
					MARYVILLE, MISSOURI 64468-0112
					(660) 582-4614 FAX (660) 582-4600


_____________________________________            # years in business  _________
Customer Name
_____________________________________            # years at address  __________
Address
_____________________________________            Telephone  ___________________
City, State, Zip Code                            Fax  _________________________

Federal Employer Identification Number:  ____________________________________

Ownership:    __ Corporation  __ Partnership  __ Individual

Do you claim exemption from sales tax?  ____Yes   ____ No

If yes, please attach appropriate documentation. (E.G., exemption certificate or letter)

Name(s) of Principal(s)                        Address

_______________________________________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________


Finance:

_______________________________________________________________________________________
Bank Name

______________________________________________________________________________________
Bank Officer                               Phone/Fax


Three References (Name, Address, Phone/Fax)
1_____________________________________________________________________________________ 
2_____________________________________________________________________________________
3_____________________________________________________________________________________

Signature:___________________________________

Date:______________________   Title:________________________________