Feel free to fill out and submit our online Maryland Chemical Customer Credit Application or click here for a form to print and fax back to us

Credit Application
Name:
Address:
Telephone:
Fax:
CONTACTS
Purchasing:
Account Payable:
Officers:
FORM OF BUSINESS
Select Form of Business:
Federal Tax ID#:
Type of Business:
Date Started:
Annual Sales:
D & B#:
Amount of Credit Requested:
BANK REFERENCE
Name of Bank:
Address:
Telephone:
Contact:
Your Account # at Bank:
TRADE REFERENCES
Name:
Address:
Telephone:
Fax:
Contact:
Name:
Address:
Telephone:
Fax:
Contact:
Name:
Address:
Telephone:
Fax:
Contact:


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Maryland Chemical Company, Inc.
3310 Childs Street
Baltimore, MD 21226

Toll Free: 800-2921967
Voice: 410-752-1800
Fax: 410-752-0001

Copyright 2001 MARYLAND CHEMICAL CO.