NASH LIFT CREDIT APPLICATION Please enter the following information, print this page, then mail or fax to: Nash Lift Truck Supply Co LLC 200 Delta Dr. Nicholasville, KY 40356 Phone: 859-881-1577 Fax: 859-881-1490

COMPANY PHONE FAX EMAIL BILLING ADDRESS: ADDRESS CITY STATE ZIP COUNTRY SHIPPING ADDRESS: ADDRESS CITY STATE ZIP COUNTRY DATE BUSINESS ESTABLISHED AMOUNT OF CREDIT REQUIRED   (If over $25,000, include current financial statement) ARE YOU SALES TAX EXEMPT? Yes No   (If yes, please provide a copy of your Tax Exempt Cert.) OWNERSHIP Sole Ownership Partnership Corporation   FEDERAL ID # DUNS # OWNERS AND OFFICERS: NAME TITLE ADDRESS SOC. SEC. # PHONE   NAME TITLE ADDRESS SOC. SEC. # PHONE HAVE ANY OF THE ABOVE BEEN INVOLVED IN BANKRUPTCY WITHIN THE LAST (10) TEN YEARS? Yes No IF YES, UNDER WHAT NAME? NAME CITY STATE DISPOSITION IF COMPANY IS LESS THAN (2) YEARS OLD, PROVIDE INFORMATION CONCERNING PREVIOUS EMPLOYMENT OF PRINCIPLE OWNER(S): COMPANY TITLE PHONE   COMPANY TITLE PHONE   COMPANY TITLE PHONE LIST (3) THREE SUPPLIERS AND YOUR PRIMARY BANK (required information): NAME ADDRESS PHONE FAX   NAME ADDRESS PHONE FAX   NAME ADDRESS PHONE FAX   NAME ADDRESS PHONE FAX