Wells Fargo Credit Request

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Record Type

Client Code

Tradestyle

PO NUmber

Request Date

Ship Date (Cancel Date)

Request Type

Amount Requested

Terms Code

Terms Description

Bill to Customer ID

Bill to Customer Name

Bill to Customer Address1

Bill to Customer Address2

Bill to Customer City

Bill to Customer State

Bill to Customer Country

Bill to Customer Zip Code

Bill to Customer Phone

Customer Store Number