"Credit Application Form - Packaging Supplies"

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CREDIT APPLICATION
Date
:
Trade Name
Phone
:
Legal Name
Fax
:
Billing Address
City
State
Zip
:
Shipping Address
City
State
Zip
:
Website Address
Email Address
:
Check One
__Proprietorship
__Partnership
__Corporation
Please completely fill out the box below for Proprietorships and Partnerships.
For Corporations, please include all of the officers’ names and titles.
NAME
TITLE
HOME ADDRESS
SOC. SEC.#
PHONE#
_____________ ________ ______________________ _____________ _________
_____________ ________ ______________________ _____________ _________
:
Federal ID#
Date Incorporated
Contact Person
TRADE REFERENCES
:
Name
Address
State
Zip
:
Phone
Fax
Account#
:
Name
Address
State
Zip
:
Phone
Fax
Account#
:
Name
Address
State
Zip
:
Phone
Fax
Account#
BANK REFERENCE
Name of Bank
__Checking
__Savings
:
Bank Address
Phone
Account#
Applicant agrees that the extension of credit shall be subject to and in consideration of the following terms and conditions:
1) Payment will be made of all amounts due as indicated on each invoice. Our terms are Net 30 Days.
2) Amounts not paid on time are subject to a 1% per month (or maximum allowable charge by law in the state in which
the sale is made) late-payment charge to be assessed from the first day that the balance is past-due. However, no such
charge shall be imposed when doing so would violate law.
3) Should it be necessary to refer the account balance to a licensed collection agency or attorney for legal action,
applicant agrees to pay a 20% collection fee, reasonable attorney fees and court costs.
4) Application authorizes and grants the seller the right to investigate credit references and banking information listed.
5) I (We) have read the above agreement.
:
Signed
:
Print
:
Title
PackagingSupplies.com 16363 Pearl Road Cleveland, OH 44136
Phone: 800-536-3668 Fax: 440-846-1692
CREDIT APPLICATION
Date
:
Trade Name
Phone
:
Legal Name
Fax
:
Billing Address
City
State
Zip
:
Shipping Address
City
State
Zip
:
Website Address
Email Address
:
Check One
__Proprietorship
__Partnership
__Corporation
Please completely fill out the box below for Proprietorships and Partnerships.
For Corporations, please include all of the officers’ names and titles.
NAME
TITLE
HOME ADDRESS
SOC. SEC.#
PHONE#
_____________ ________ ______________________ _____________ _________
_____________ ________ ______________________ _____________ _________
:
Federal ID#
Date Incorporated
Contact Person
TRADE REFERENCES
:
Name
Address
State
Zip
:
Phone
Fax
Account#
:
Name
Address
State
Zip
:
Phone
Fax
Account#
:
Name
Address
State
Zip
:
Phone
Fax
Account#
BANK REFERENCE
Name of Bank
__Checking
__Savings
:
Bank Address
Phone
Account#
Applicant agrees that the extension of credit shall be subject to and in consideration of the following terms and conditions:
1) Payment will be made of all amounts due as indicated on each invoice. Our terms are Net 30 Days.
2) Amounts not paid on time are subject to a 1% per month (or maximum allowable charge by law in the state in which
the sale is made) late-payment charge to be assessed from the first day that the balance is past-due. However, no such
charge shall be imposed when doing so would violate law.
3) Should it be necessary to refer the account balance to a licensed collection agency or attorney for legal action,
applicant agrees to pay a 20% collection fee, reasonable attorney fees and court costs.
4) Application authorizes and grants the seller the right to investigate credit references and banking information listed.
5) I (We) have read the above agreement.
:
Signed
:
Print
:
Title
PackagingSupplies.com 16363 Pearl Road Cleveland, OH 44136
Phone: 800-536-3668 Fax: 440-846-1692
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