Noble Wire & Terminal Corp. - Bank Information Request

	® The Complete Wholesale Line of Terminals, Wire and Wiring Devices, Nationwide Automotive - Truck - Marine - Farm - Industrial	Made in the U.S.A. 1620 32nd St. Springfield, OR 97478 (800) 547-4711 FAX (541) 744-1173 Phone (541) 744-0630

Bank Credit Information Request

Please provide your bank's credit information for the account listed below. This information is requested for use toward the extension of credit for business purposes only and will be held in strict confidence.

Account:

Name: ___________________________________________________________________

Street Address: _____________________________________

PO Box: ______________

City: ______________________________

State: _______

Zip: _________________

Phone: ____________________________

Fax: ____________________________

Depository Accounts:

Date Opened: ___/___/___ If closed, when? ___/___/___

Average Balance: $_______________

Aggregate Balances used? $_______________

Experience and comments:

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

Loan Accommodations:

Describe, including length of borrowing relationship, high credit, types of loan accommodations (line of credit, term loan, mortgage, installment, etc.), amount outstanding, amount past due (if any), collateral, guarantees and endorsements (if any).

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

______________________________
Signature of Banker ___/___/___
Date

______________________________
Banker's Title