APPLICATION FOR CREDIT
Business Name:
Date Established:
Type of Ownership: Corporation
Sole
Proprietorship
Partnership
Other
Taxpayer's Federal ID Number (9 digits)
-
Tax Exempt Number
(If you are Tax Exempt, please forward a
copy of your Tax Exempt Certificate signed
by an officer of the company)
Owner's Name
Social Security Number
Officers:
Title
Title
Accounts Payable Contact
Extension
Bank Name
Address
Telephone
FAX
Account Number
Credit References
(1) Name
Account Number
Street Address
City, State, Zip Code
Telephone
FAX
(2) Name
Account Number
Street Address
City, State, Zip Code
Telephone
FAX
(3) Name
Account Number
Street Address
City, State, Zip Code
Telephone
FAX
Amount of Credit Requested $
Purchase Order Required? Yes
No
CREDIT POLICY FOR CHARGE ACCOUNTS
Upon approval of this application, it is
agreed that all purchases will be paid in
full and in accordance with the terms of
sale as stated on RnD Products invoices.
If I/We do not pay RnD Products according to
terms, it is understood that accredit
privileges may be withdrawn, deliveries
held, and 1.33% per month service charge
will be added to your past due balance. If
RnD Products finds it necessary to obtain
assistance in collecting any past due
balance, I/We agree to pay reasonable
attorney fees, collection fees, and/or court
costs allowable by law.
If a check is returned to RnD Products by
the Customer's bank for non-sufficient
funds, a charge of $21.00 will be issued to
the Customer. The Customer is required to
replace the NSF check plus the $21.00 charge
with cash, money order, or certified check.
The above information as stated on the three
mentioned pages, is warranted to be true in
support of this application. RnD Products
is hereby authorized to obtain credit and/or
financial information from my/our bank and
other financial institutions or commercial
firms with whom I/We have done business. It
is understood that any such credit and/or
financial information will be held in strict
confidence and used only in consideration of
this application. I/We have read and fully
understand the above credit policy.
Company Name
By
Title
Date
By
Title
Date
Please print an original copy with officer's
signatures to finalize the application
process.