DASHEW SUPPLY CO., INC.

2012 Renard Ct. Ste. L                               410-573-1567

Annapolis, MD 21401                                410-573-1679-fax           
 


The undersigned company is applying for credit with  and agrees to abide by the standard terms and conditions of  as printed on the reverse side.

 

Company name

 

DBA (if different)

Contact person

Address

Phone

Fax

e-mail:

Federal or State Tax  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

 

 

       SOLE PROPRIETORSHIP

Are you sales tax exempt?

       Yes

       No

Have you ever had credit with us before?

       Yes

      No

If yes, under what name?

 

Authorized purchasers

 

 

Purchase order required?

 

       Yes

       No

 

WE MUST HAVE FAX NUMBER!

 

TRADE REFERENCES                                                                              

                                        

Reference #1

Name

 

Address

 

 

Phone                                                                      FAX:

Reference #2

Name

 

Address

 

 

Phone                                                                      FAX:

Reference #3

Name

 

Address

 

 

Phone                                                                      FAX:

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  to extend credit to the applicant. My company and I authorize  to make such credit investigation as  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  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.

 

Authorized signature:

Printed name:

Title:

Date:

 

GENERAL TERMS AND CONDITIONS AND PERSONAL GUARANTEE

All bills become payable in full on day of reciept not paid by the end of the month are considered past due.

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.