| Company Legal Name (Required) | DBA or Other Trade Name (if known) | Owner/Principal Name | Owner/Principal Title | Street Address | Phone (Area Code +7 digits) | Phone (International) | EIN (##-#######) - Tax ID; Masked showing only last 4 numbers | Requester's Trade Experience Infomration | As a representative of my company, I have read and consent to abide by BCI's Trade Credit Exchange Code of Conduct | Requesting Client Number | Requester Email | Pick the Group to Receive Your Reference Request | | Account Status | Reason for Requesting a Reference | File - Upload credit application and submit request | Tradeline Date | High Credit (dollars/no cents) | Total Balance (Will auto calculate) | Current - (dollars/no cents) | 1-30 Days (dollars/no cents) | 31-60 Days (dollars/no cents) | 61-90 Days (dollars/no cents) | 91-120 Days (dollars/no cents) | 120+ Days (dollars/no cents) | ADP | DBT | Payment Terms | Payment Method | | Payment Alert/Pattern | | | Security/Account Type | Date Created | Date Updated | Gravatar | Gravity Forms | Entry ID | Approval Status | Source ID | Source URL | Requesting Trade Experience On: | Company Legal Name (Required) | DBA or Other Trade Name (if known) | Owner/Principal Name | Owner/Principal Title | Address | Phone (Area Code +7 digits) | Phone (International) | EIN (##-#######) - Tax ID; Masked showing only last 4 numbers | Requester's Trade Experience Infomration | As a representative of my company, I have read and consent to abide by BCI's Trade Credit Exchange Code of Conduct | Requesting Client Number | Requester Email | Pick the Group to Receive Your Reference Request | | Account Status | Reason for Requesting a Reference | File - Upload credit application and submit request | Tradeline Date | High Credit (dollars/no cents) | Total Balance (Will auto calculate) | Current - (dollars/no cents) | 1-30 Days (dollars/no cents) | 31-60 Days (dollars/no cents) | 61-90 Days (dollars/no cents) | 91-120 Days (dollars/no cents) | 120+ Days (dollars/no cents) | ADP | DBT | Payment Terms | Payment Method | | Company Legal Name (Required) | DBA or Other Trade Name (if known) | Owner/Principal Name | Owner/Principal Title | Street Address |
| Company Legal Name (Required) | DBA or Other Trade Name (if known) | Owner/Principal Name | Owner/Principal Title | Street Address | Phone (Area Code +7 digits) | Phone (International) | EIN (##-#######) - Tax ID; Masked showing only last 4 numbers | Requester's Trade Experience Infomration | As a representative of my company, I have read and consent to abide by BCI's Trade Credit Exchange Code of Conduct | Requesting Client Number | Requester Email | Pick the Group to Receive Your Reference Request | | Account Status | Reason for Requesting a Reference | File - Upload credit application and submit request | Tradeline Date | High Credit (dollars/no cents) | Total Balance (Will auto calculate) | Current - (dollars/no cents) | 1-30 Days (dollars/no cents) | 31-60 Days (dollars/no cents) | 61-90 Days (dollars/no cents) | 91-120 Days (dollars/no cents) | 120+ Days (dollars/no cents) | ADP | DBT | Payment Terms | Payment Method | | Payment Alert/Pattern | | | Security/Account Type | Date Created | Date Updated | Gravatar | Gravity Forms | Entry ID | Approval Status | Source ID | Source URL | Requesting Trade Experience On: | Company Legal Name (Required) | DBA or Other Trade Name (if known) | Owner/Principal Name | Owner/Principal Title | Address | Phone (Area Code +7 digits) | Phone (International) | EIN (##-#######) - Tax ID; Masked showing only last 4 numbers | Requester's Trade Experience Infomration | As a representative of my company, I have read and consent to abide by BCI's Trade Credit Exchange Code of Conduct | Requesting Client Number | Requester Email | Pick the Group to Receive Your Reference Request | | Account Status | Reason for Requesting a Reference | File - Upload credit application and submit request | Tradeline Date | High Credit (dollars/no cents) | Total Balance (Will auto calculate) | Current - (dollars/no cents) | 1-30 Days (dollars/no cents) | 31-60 Days (dollars/no cents) | 61-90 Days (dollars/no cents) | 91-120 Days (dollars/no cents) | 120+ Days (dollars/no cents) | ADP | DBT | Payment Terms | Payment Method | | Company Legal Name (Required) | DBA or Other Trade Name (if known) | Owner/Principal Name | Owner/Principal Title | Street Address |