Credit Requested *Estimated Annual Purchases $      *Credit Limit Requested $       Sales Rep Name       Setup for GEAR___ CCP___ Both___      Company Information *Business Name       Doing Business As (DBA Name)      *Billing Address      *City      *State/ Province AKALARASAZCACOCTDCDEFLFMGAGUHIIAIDILINKSKYLAMAMDMEMHMIMNMOMPMSMTNCNDNENHNJNMNVNYOHOKORPAPRPWRISCSDTNTXUTVAVIVTWAWIWVWYABBCMBNBNLNSNTNUONPEQCSKYT      *Zip/Postal       Country United States Of AmericaCanada      *Billing Address      *City      *State/ Province AKALARASAZCACOCTDCDEFLFMGAGUHIIAIDILINKSKYLAMAMDMEMHMIMNMOMPMSMTNCNDNENHNJNMNVNYOHOKORPAPRPWRISCSDTNTXUTVAVIVTWAWIWVWYABBCMBNBNLNSNTNUONPEQCSKYT      *Zip/Postal       Country United States Of AmericaCanada      *Shipping Address      *City      *State/ Province AKALARASAZCACOCTDCDEFLFMGAGUHIIAIDILINKSKYLAMAMDMEMHMIMNMOMPMSMTNCNDNENHNJNMNVNYOHOKORPAPRPWRISCSDTNTXUTVAVIVTWAWIWVWYABBCMBNBNLNSNTNUONPEQCSKYT      *Zip/Postal       Country United States Of AmericaCanada      *Accounts Payable Contact Name      *Telephone      *Email Address      *Application Contact Name      *Telephone - Work       Application Contact Email Address       Name of Purchaser       Purchaser Phone Number       Purchaser Email       Email Invoices To       Years In Business       Legal Structure       Tax Exempt (Yes or No)       Customer Class (i.e. Book, Golf, Retail)       Institution      Trade Reference Information  Reference Name       Reference Account Number       Phone Number       Reference Email       Contact Name       Phone Number       Contact Email       Reference Name       Reference Account Number       Phone Number       Reference Email       Contact Name       Phone Number       Contact Email       Bank Name       Bank Account Number       Bank Contact       Bank Contact Phone Number       Bank Contact Email Address      Attachments IMPORTANT: PLEASE NOTE that an Exemption Certificate and or Multi-Jurisdiction Form is required, covering each state shipped to. IF TAX EXEMPT WE MUST HAVE YOUR CERTIFICATE TO SET UP THE ACCOUNT. If you are unable to attach the certificate to this application please email to newaccts@hanes.com. Also please enclose a copy of your latest financial statement to assist in our review. **YOU MUST ATTACH THE FORM BY CLICKING ON THE UPLOAD BUTTON.** Attachment Description Attachment Location Upload Upload Upload Note: Accepted file formats include PDF, CSV, TXT and various image files (JPEG, JPG, GIF, BMP, TIFF, TIF, PNG, ICO). File attachments must not exceed 10 MB in combined size.

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