Credit Application
La Bolt Farmers Grain Co.
PO Box 91
LaBolt, SD 57246
Tel. 800-658-3692    Fax 605-623-4227

Credit Application for Open Account

You can also fill out a physical form here and mail it or email it to La Bolt Farmers Grain Co.
Customer/Business Name  
Phone:  
Fax  
Social Security Number / TIN 
City  
State  
ZIP  
Sole Proprietorship  
Partnership  
Corporation  
Other, please describe:  
How long at current address? 
Bank Name  
Bank Address  
Bank City  
Bank State  
Bank ZIP  
Type of Account  
Account Number  
Please type the text in the box.


   
  

Agreement:
  1. All invoices are to be paid the 15th of the next month following purchase.
  2. Claims arising from invoices must be made within seven (7) working days.
 
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