"Credit Application and Trade References Form - Independent Folders"

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Download "Credit Application and Trade References Form - Independent Folders"

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CREDIT APPLICATION
In order for you to open an account with our company, we ask that you fill out the following information completely.
Company Name
______________________________________________________________________________________________________
Street Address (required) ________________________________________________________________________________________________
City
_______________________________________________________
State ___________________
Zip _____________________
Billing Address
_______________________________________________________________________________________________________
City
_________________________________________________________
State ___________________
Zip _____________________
Phone ( _________ ) ______________________
Fax ( ________) _______________________
Years in Business
____________
Parent Company or Affiliation Number of Employees __________________________________________________________________________
Address _____________________________________________________________________________________________________________
City
_________________________________________________________
State ___________________
Zip _____________________
President ______________________________________________
Controller
_________________________________________________
Form of Organization
Corporation
Partnership
Sole Proprietor
LLC/LLP
Nature of Business ____________________________________________________________________
SIC Code ____________________
Approximately what do you anticipate will be your monthly purchases? ____________________________________________________________
Will your purchases be subject to Wisconsin sales tax? ________________________________________________________________________
If not, please enclose the appropriate exemption certificate, if applicable.
TRADE REFERENCES
Name
______________________________________________________________________________________________________________
Address _____________________________________________________________________________________________________________
City
_________________________________________________________
State ___________________
Zip _____________________
Phone ( _________ )
____________________________________
Fax ( _______________)
__________________________________
Name
______________________________________________________________________________________________________________
Address _____________________________________________________________________________________________________________
City
_________________________________________________________
State ___________________
Zip _____________________
Phone ( _________ )
____________________________________
Fax ( _______________)
__________________________________
Name
______________________________________________________________________________________________________________
Address _____________________________________________________________________________________________________________
City
_________________________________________________________
State ___________________
Zip _____________________
Phone ( _________ )
____________________________________
Fax ( _______________)
__________________________________
The back of this application must be completed prior to processing.
CREDIT APPLICATION
In order for you to open an account with our company, we ask that you fill out the following information completely.
Company Name
______________________________________________________________________________________________________
Street Address (required) ________________________________________________________________________________________________
City
_______________________________________________________
State ___________________
Zip _____________________
Billing Address
_______________________________________________________________________________________________________
City
_________________________________________________________
State ___________________
Zip _____________________
Phone ( _________ ) ______________________
Fax ( ________) _______________________
Years in Business
____________
Parent Company or Affiliation Number of Employees __________________________________________________________________________
Address _____________________________________________________________________________________________________________
City
_________________________________________________________
State ___________________
Zip _____________________
President ______________________________________________
Controller
_________________________________________________
Form of Organization
Corporation
Partnership
Sole Proprietor
LLC/LLP
Nature of Business ____________________________________________________________________
SIC Code ____________________
Approximately what do you anticipate will be your monthly purchases? ____________________________________________________________
Will your purchases be subject to Wisconsin sales tax? ________________________________________________________________________
If not, please enclose the appropriate exemption certificate, if applicable.
TRADE REFERENCES
Name
______________________________________________________________________________________________________________
Address _____________________________________________________________________________________________________________
City
_________________________________________________________
State ___________________
Zip _____________________
Phone ( _________ )
____________________________________
Fax ( _______________)
__________________________________
Name
______________________________________________________________________________________________________________
Address _____________________________________________________________________________________________________________
City
_________________________________________________________
State ___________________
Zip _____________________
Phone ( _________ )
____________________________________
Fax ( _______________)
__________________________________
Name
______________________________________________________________________________________________________________
Address _____________________________________________________________________________________________________________
City
_________________________________________________________
State ___________________
Zip _____________________
Phone ( _________ )
____________________________________
Fax ( _______________)
__________________________________
The back of this application must be completed prior to processing.
This information is submitted by the undersigned for the purpose of obtaining credit. THE UNDERSIGNED AGREES TO PAY ALL INVOICES WITHIN
THE TERMS OF SALE. ACCOUNTS OVER 30 DAYS ARE SUBJECT TO A LATE PAYMENT CHARGE OF 1-1/2% PER MONTH. Purchaser agrees to
pay in accord with the foregoing terms of sale and further agrees to pay all collection costs and reasonable attorney’s fees necessary to collect past due
amounts, as permitted by law; legal action to enforce this agreement may be brought in the State of Wisconsin, County of Brown.
This application does not constitute the granting of credit. You will be notified of terms we are extending within seven days of receipt of this application.
Orders placed before the credit approval process has been completed, will require 50% down with the order (subject to certain size limitations).
The undersigned does hereby apply for credit with Independent Printing and gives them permission to contact any and all references for the purpose of
establishing a credit profile.
Company _______________________________________________________________
Date ________________________________________
By
____________________________________________________________________
Title ________________________________________
(Must be signed by an officer or owner)
PERSONAL GUARANTEE: In consideration for credit extended or to be extended to the above company,I/we do
hereby agree, individually/jointly, to guarantee payment of the indebtedness of the company. The undersigned
expressly waives all notice of acceptance of this guarantee, notice of extension of credit, presentment of demand
for payment, any notice of default, and all other notices the guarantor might be entitled to. This guarantee shall inure
to the benefit of the heirs, administrators, executors, successors, or assigns of the parties hereto.
By: _________________________________________
__________________________________________
_________________________
(Signature)
(Print Name of Guarantor)
(Date)
By: _________________________________________
__________________________________________
_________________________
(Signature)
(Print Name of Guarantor)
(Date)
Attention (Your ASR): _______________________________________
Upon completion, fax this credit application to 866.584.8938.
IPCADM304(1.14)
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