References

Credit Information

1.

Company Name________________________

Company Name________________________

Address______________________________

Billing Address_________________________

_____________________________________

_____________________________________

Phone #______________________________

Phone #______________________________

Fax #________________________________

Fax #________________________________

Contact______________________________

Financial Contact______________________

2.

Company Name________________________

Organization Type:

Address______________________________

(   ) Sole Proprietorship

_____________________________________

(   ) Partnership

Phone #______________________________

(   ) Corporation

Fax #________________________________

Year Established_______________________

Contact______________________________

Resale #______________________________

3.

Company Name________________________

Principles:

Address______________________________

Owner/President_______________________

_____________________________________

Vice President_________________________

Phone #______________________________

Principle Bank Address_________________

Fax #________________________________

_____________________________________

Contact______________________________

_____________________________________

Phone #______________________________

Authorization

Account #____________________________

I hereby authorize the release of information to SAICOM from
 the bank and references listed above. The undersigned customer
hereby applies for trade credit with SAICOM. Customer agrees
to pay all amounts owed to SAICOM in accordance with
SAICOM's standard terms and conditions of sale incorporated
herein by reference, including any check purchases that are
returned.

As stated in SAICOM's terms and conditions of sale, Customer
is responsible for the late fees and court costs. Customer warrants
that all the information provided in this application and any
supporting documents are true in all material respects, and that
any false or misleading information can result in the restriction or
 revocation of customer's authorizes the release of the credit
 information for that purpose.

Contact Person________________________

Title__________________________________

Dunn and Brastreet #____________________

_____________________________________

Saicomm, Inc.

Authorized Signature

1340 Fulton Pl. Fremont, CA 94539

_____________________________________

Phone: 510-438-4550     Fax: 510-770-8658

Name

Date

Email: sales@saicomm.com Web: www.saicomm.com