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Credit Information FormBUSINESS NAME (Full Name):_________________________________________________________MAILING ADDRESS:__________________________STREET ADRESS____________________________ CITY:__________________STATE:________ZIP:____________PHONE:________________________ YEAR ESTABLISHED:__________INCORPORATED?___STATE INC.___INDIVIDUAL___PARTNERSHIP___ IF SUBSIDIARY NAME OF PARENT COMPANY_______________________________________________ ADRESS_____________________________________________________________________________ CORPORATE OFFICERS/PARTNERS/OWNERS, ADRESS AND SOCIAL SECURITY NUMBER
NAME OF BANK:______________ACCOUNT#________________PHONE:_____________________
BUSINESS REFERENCES OR SUPPLIERS: (three)
TERMS AND CONDITIONSTerms, unless otherwise stated are net 30 days. (MOST internet prices require prepayment or credit card) In the event of judicial proceedings to enforce collections, applicant agrees to accept full liability of all attorney's fees and expenses of collection. RISK OF LOSS: When goods are delivered by a carrier, delivery to buyer shall take place when goods are placed in the hands of the carrier and any claims for loss, damage or destruction must be made by the buyer to the carrier. seller shall in no event be liable to buyer for any consequential damages of loss of goods. WAIVER: All claims shall be deemed waived unless made in writing delivered to seller within 10 days after receipt of goods by buyer. INSPECTION: Buyer shall affored seller prompt and reasonable opportunity to inspect goods as to which any claim is made as above stated. Seller reserves the right, in sole discretion, to replace any claimed defect in goods. RETURNS: No merchandise may be returned for credit without having first received prior authorization from seller. ERRORS: Seller reserves the right to correct clerical or stenographic errors or omissions in any sale transaction. ACCEPTANCE: All orders are subject to acknowledgement and acceptance by seller. APPLICANTS STATEMENT: PLEASE read this statement before you sign it All the information we have given in this application is true and correct. We understand that you will confirm the information and retain the application whether or not our application is approved. You also authorized to receive information on our credit. You can answer questions and requests form others, like stores, Banks or credit roprting agencies for credit and experience information about us and our accounts with your. I authorized the release of this information whether the signature below is orginal or a copy. PERSONAL GUARANTEE If it becomes necessary to effect legal action to collect this accoutn, the signing pary herein personally guarantees and holds himself (herself) personally liable for the corporate obligation and pledges personal responsibility for all oblighations incurred. I (we) certify that the above information is true and correct, and that I (we) can and will comply with your terms.
SIGNATURE(print/sign): ______________________________________________ |