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                                                                 Credit Application                                Fax this completed form to (914) 696-8147
                                                                                                                   or mail to The Journal News,
                                                                                                                   One Gannett Drive, White Plains, NY 10604


Account Executive: Name                                                                       Media (Newspaper, TV, Radio, Magazine)
Ext.                            Account Number                                                Media Reference #1: Name
Type of Billing:                Direct      Agency                                            Street
Type of Advertising:            Display     Classified                                        City                                                    State    Zip
Estimated Usage: $                                                per:         Month   Year   Phone                                             Fax
Account:             Name                                                                     E-mail
Street                                                                                        Media Reference #2: Name
City                                                     State           Zip                  Street
Phone                                            Fax                                          City                                                    State    Zip
E-mail                                                                                        Phone                                             Fax
Parent Company: Name                                                                          E-mail
Street                                                                                        Media Reference #3: Name
City                                                     State           Zip                  Street
Phone                                            Fax                                          City                                                    State    Zip
E-mail                                                                                        Phone                                             Fax
Billing Address, if different from above:                                                     E-mail
Street                                                                                        Personal Guarantee: I assume personal and individual respon-
City                                                     State           Zip                  sibility and liability and further guarantee payment of all advertising and
                                                                                              other charges due and payable to The Journal News, Inc. by the company or
Type of Business:           Corporation     Partnership          Proprietorship
                                                                                              corporation listed herein.
Nature of Business                                                                            Individual
Date Established                                                                              Guarantor: Signature*

Principal #1 of Firm: Name                                                                    Print Name

Social Security Number                                                                        Date

Home Address: Street                                                                          If credit is granted, I, the undersigned advertiser or agency, agree to
City                                                     State           Zip
                                                                                              pay in accordance with The Journal News credit terms. I understand
                                                                                              that default on payment may result in additional charges such as
Phone                                            Fax                                          collection or attorney fees. I affirm that all information listed on this
E-mail                                                                                        document is correct. I authorize the release of all credit / banking
Principal #2 of Firm: Name                                                                    information to The Journal News.
Social Security Number
                                                                                              Advertiser: Signature*
Home Address: Street
                                                                                              Title
City                                                     State           Zip
                                                                                              Date
Phone                                            Fax
                                                                                              * Credit Applicaiton cannot be processsed without a signature.
E-mail
Bank:        Name
                                                                                                      Credit Dept. Use Only
Street
                                                                                                        Approved       Declined
City                                                     State           Zip
Phone                                            Fax
E-mail
Account / Loan Number
Contact