Company Name:
DBA (if different):
Contact Person:
Address:
E-mail:
Phone:
Fax:
Federal tax ID or Social Security Number:
Type of business:
No. of employees:
Date business established:
Types of products you will purchase:
Amount of credit requested:
Are you a:
Corporation
State of incorporation:
Names, titles, and addresses of your three
chief corporate officers:
Name and address of your resident agent:
Partnership
Names and addresses of the partners:
Sole Proprietorship
Are you tax exempt?
Have you ever had credit with us before?
If yes under what name?
List authorized purchasers below:
Purchase order required?
Trade References:
Reference #1:
Name:
Address:
Phone:
Reference #2
Name:
Address:
Phone:
Reference #3
Name:
Address:
Phone:
Bank References
Bank #1
Account #:
Phone:
Contact person:
Name of bank:
Address:
Bank #2
Account #:
Phone:
Contact person:
Name of bank:
Address:
I represent that the above information is
true and is given to induce Crawfordsville Paper Products,
Inc. to extend credit to the applicant. My company and I
authorize Crawfordsville Paper Products, Inc. to make such
credit investigation as Crawfordsville Paper Products, Inc.
sees fit, including contacting the above trade references
and banks and obtaining credit reports. My company and I
authorize all trade references, banks, and credit reporting
agencies to disclose to Crawfordsville Paper Products, Inc.
any and all information concerning the financial and credit
history of my company and myself.
I have read the terms and conditions stated
below and agree to all of these terms and conditions.
Placing an "X" in the box below
and submitting this form is considered a legal authorized
signature.
Authorized Signature:
Name:
Title:
Date:
Terms are net 10 days. All bills become payable in full on the 11th day
after receipt of the invoice and if not paid are considered
past due. A service charge of 1.5% per month will be added
to all amounts billed if not paid by the agreed terms. No additional credit will be extended to past
due accounts unless satisfactory arrangements are made
with our credit department. PERSONAL GUARANTEE: If the credit customer is
a corporation, then those signing this application,
whether signing as an officer or not, personally guarantee
payment for all items purchased on credit by the corporation.
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