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A/R CREDIT REQUEST
REQUESTS ARE NOT APPROVALS.
Enter Required Information Below to Request Account Credit
COWART COMPANY/ENTITY:
CUSTOMER ACCOUNT NAME
CUST. ACCOUNT NUMBER
INVOICE OR P.O. #
CREDIT AMOUNT
PRIMARY REASON
Select (Required)
SECONDARY REASON
Select (optional)
SUPPORTING IMAGES/PICTURES
UPLOAD 15MB MAX
SUPPORTING FILES/DOCUMENTS
UPLOAD 15MB MAX
SUPPORTING NOTES & INFO
REQUESTED BY:
SUBMIT REQUEST
APPROVED BY:______________
DATE:______________
CREDIT ISSUE DATE:______________
CREDIT NUMBER:______________
- THIS SECTION FOR OFFICE USE ONLY -
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