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ROBINSON SALT SUPPLY, INC.
1202 PINE KNOLL COURT
MIAMISBURG, OHIO 45342
(937) 866-7272
(614) 857-9100
Outside Ohio 1-800-898-7258 (SALT)
Fax (937)866-3071
WWW.ROBINSONSALTSUPPLY.COM
Date: _____________
Name:__________________
Address: _______________
________________________
Phone:_________________
Fax:____________________
Email:__________________
To: _______________
Please provide three (3) credit references with your application for credit. Please include: Business name,
Contact person, Business phone number, and Fax numbers.
Without this information, it will delay the processing of your account for credit.
1) _____________________________________________________________________
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_______________________________________________________________________
_______________________________________________________________________
2) _____________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
3) _____________________________________________________________________
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Thanks for your assistance in this matter.
Robinson Salt Supply, Inc.