Springfield Lumber Company - Credit Application Form

Credit Application Form

Name of Business
Address
City
State
Zip
Nature of Business
Phone
Tax Exempt #
please fax copy to this number:

Name of Officers or Principals
Officer 1
Name
Title
Address
City
State
Zip
Phone

Officer 2
Name
Title
Address
City
State
Zip
Phone
We estimate our monthly requirements to be $

Bank References:
Bank Name
Street Address
Officer
City
State
Zip
Phone

Trade References:
Reference 1
Name
Address
City
State
Zip
Phone
Fax

Reference 2
Name
Address
City
State
Zip
Phone
Fax

Reference 3
Name
Address
City
State
Zip
Phone
Fax

Reference 4
Name
Address
City
State
Zip
Phone
Fax

Conditions of Sale and Terms of Payment - Net 30
In consideration for any extension of credit, purchaser agrees to the terms hereof and to the conditions of sale set forth on each invoice, purchaser also agrees to pay a service charge of two (2%) per month ( or the maximum allowable contract rate under state statutes) computed on the unpaid delinquent balance until the account is paid in full. The purchaser also agrees to pay reasonable attorney fees and other costs incurred for collection.
Authorized Name:
If the purchaser is a closely held corporation the president and/or treasurer signing this application on behalf of the corporation do/does hereby personally guarantee any obligation of the corporation which may arise on accoont of any extension of credit.
Authorized Name:
Title: