CREDIT APPLICATION ( ) NEW ACCOUNT
( ) CHANGE OF NAME
( ) CHANGE OF OWNERSHIP
CORPORATION ( )
PRINT ALL INFORMATION PARTNERSHIP ( )
_________________ PROPRIETORSHIP ( )
EXACT NAME OF OWNER(S) OR CORP: ______________________________________________________________________ D/B/A, IF DIFFERENT: ______________________________________________________________________________________ DELIVERY ADDRESS: ______________________________________________________________________________________ CITY/STATE/ZIP MAILING/BILLING ADDRESS: _______________________________________________________________________________ CITY/STATE/ZIP TYPE OF BUSINESS: __________________________PHONE:( )___________FAX:( )_____________________________ BOOKKEEPER/ACCOUNTANT/ACCOUNTS PAYABLE SUPERVISOR: _____________________________________________ ___________________________________________________________________________________________________________ _ NAME OF MANAGER: ______________________________________________________________________________________ _ DATE BUSINESS ESTABLISHED:_____________________________________ PREVIOUS BUSINESS OWNED ____Y ____N (UNDER CURRENT OWNERSHIP) NAME:___________________________________________ OWNER(S) /OFFICERS(S) NAME(S) AND HOME ADDRESSES: NAME AND TITLE STREET ADDRESS CITY/STATE/ZIP PHONE ___________________________________________________________________________________________________________ _ ___________________________________________________________________________________________________________ _ ___________________________________________________________________________________________________________ _ IF CORPORATION OR PARTNERSHIP, LIST THE FOLLOWING: HEADQUARTERS ADDRESS:_________________________________________________________________________________ FEDERAL ID # OR STATE SALES TAX # ___________________________________________BUSINESS LIC. # _____________________________ NAME OF BANK(S):____________________________________________ACCOUNT #__________________________________ ___________________________________________________________________________________________________________ _ BANK ADDRESS CITY/STATE ZIP PHONE NAME(S) OF PERSON(S) SIGNING CHECKS: (PLEASE PRINT) ______________________________________________________DRIVERS LICENSE #__________________________________ ______________________________________________________DRIVERS LICENSE #__________________________________ TRADE REFERENCES (LOCAL PREFERRED): NAME ADDRESS
CITY/STATE/ZIP
PHONE
___________________________________________________________________________________________________________ _ ___________________________________________________________________________________________________________ _ ___________________________________________________________________________________________________________ _ THE INDIVIDUAL(S) SIGNING THIS APPLICATION HEREBY AGREE AS FOLLOWS:
1. CUSTOMER MUST MEET MINIMUM ORDER REQUIREMENT.
2. ANY CLAIMS MUST BE FILED WITHIN 24 HOURS, AND MERCHANDISE ACCEPTED FOR RETURN AFTER 15 DAYS IS SUBJECT TO RESTOCKING CHARGE. ALL MERCHANDISE MUST BE IN ITS ORIGINAL CASE AND COMPLETE. MERCHANDISE ACCEPTED FOR RETURN IS ACCEPTED FOR CREDIT OR EXCHANGE ONLY. NO CASH REFUNDS. A CREDIT MEMO WILL BE ISSUED FOR RETURNED MERCHANDISE. ALL CONTRACTS SUBJECT TO CONTINGENCIES OF TRANSPORTATION, STRIKES AND OTHER UNAVOIDABLE ACCIDENTS OR CAUSES BEYOND OUR CONTROL ALL QUOTATIONS FOR IMMEDIATE ACCEPTANCE AND SUBJECT TO CHANGE WITHOUT NOTICE.
3. APPLICANT WILL BE NOTIFIED IF ANY CHECK IS RETURNED UNPAID. ONLY A CASHIER’S CHECK,
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MONEY ORDER OR CASH WILL BE ACCEPTED FOR PAYMENT ON THE RETURNED CHECK. IT IS NOT OUR POLICY TO REDEPOSIT THE RETURNED CHECK. A FEE TO COMPLY WITH FLORIDA STATUTE 68.065 WILL BE CHARGED AND MUST BE INCLUDED WITH THE PAYMENT. ORDERS WILL BE SENT CASH ONLY UNTIL THE MATTER IS CLEARED. THE TERMS OF YOUR ACCOUNT WILL BE CHANGED TO CASH ONLY C.O.D. IF A SECOND CHECK IS RETURNED. BY SIGNATURE (S) BELOW, APPLICANT REPRESENTS AND WARRANTS THAT ALL STATEMENTS MADE HEREIN ARE TRUE AND CORRECT, AND THAT THE APPLICANT AGREES TO PAY ALL INVOICES IN ACCORDANCE WITH THE TERMS HEREOF AND THE TERMS OF EACH INVOICE, TOGETHER WITH INTEREST AT THE HIGHEST LEGAL RATE ALLOWED BY LAW. IF PENINSULAR PAPER COMPANY, INC. EMPLOYS AN ATTORNEY AND/OR INSTITUTES SUIT TO EFFECT COLLECTION OF THIS ACCOUNT, APPLICANT AGREES TO PAY A REASONABLE ATTORNEY’S FEE AND ALL COSTS INCURRED BY PENINSULAR PAPER COMPANY, INC. WHETHER INCURRED THROUGH LITIGATION OR OTHERWISE, AND FURTHER AGREES THAT THE ABOVE-SAID INTEREST AT THE HIGHEST RATE ALLOWED BY LAW SHALL CONTINUE AFTER ENTRY OF JUDGMENT ON ALL AMOUNTS FOUND TO BE DUE AND OWING, INCLUDING COSTS AND FEES, AND SHALL BE INCORPORATED INTO ANY SUCH JUDGMENT ENTERED. ALL ACCOUNTS ARE DUE AND PAYABLE AT TAMPA, HILLSBOROUGH COUNTY, FLORIDA. APPLICANT HEREBY WAIVES THE RIGHT TO BE SUED IN ANY OTHER COUNTY OR JURISDICTION, AND AGREES THAT IF LEGAL ACTION IS INSTITUTED, VENUE AND THE PLACE OF ALL DISCOVERY SHALL BE IN HILLSBOROUGH COUNTY, FLORIDA. FURTHER, THE PLACE OF POST-JUDGMENT PROCEEDINGS, INCLUDING THE TAKING OF DEPOSITIONS OR OTHER DISCOVERY IN AID OF EXECUTION, SHALL BE IN HILLSBOROUGH COUNTY, FLORIDA. THIS AGREEMENT CONSTITUTES THE ENTIRE AGREEMENT BETWEEN THE PARTIES, AND NO PRIOR ORAL OR WRITTEN REPRESENTATIONS, PROMISES OR UNDERTAKINGS SHALL AFFECT, VARY, ALTER OR MODIFY THE TERMS HEREOF. THIS AGREEMENT SHALL BE GOVERNED BY AND ENFORCED UNDER THE LAWS OF FLORIDA AND MAY NOT BE MODIFIED, ALTERED OR AMENDED EXCEPT BY WRITTEN AGREEMENT SIGNED BY THE PARTIES HERETO. NO FAILURE OF PENINSULAR PAPER COMPANY, INC. TO EXERCISE ANY RIGHTS HEREUNDER OR TO INSIST UPON STRICT COMPLIANCE HEREUNDER, AND NO CUSTOMARY PRACTICE OF THE PARTIES AT VARIANCE TO THE TERMS HEREOF, SHALL CONSTITUTE A WAIVER OF THE RIGHTS OF PENINSULAR PAPER COMPANY, INC. TO DEMAND COMPLIANCE WITH THE TERMS HEREOF IN THE EVENT OF SUBSEQUENT DEFAULT. IF APPLICANT IS A CORPORATION OR A PARTNERSHIP, THE PERSONS SIGNING THIS AGREEMENT ON BEHALF OF SUCH CORPORATION OR PARTNERSHIP HEREBY WARRANT THAT THEY HAVE FULL AUTHORITY FROM SUCH CORPORATION OR PARTNERSHIP TO SIGN THIS AGREEMENT AND OBLIGATE THE CORPORATION OR PARTNERSHIP HEREUNDER, AND THE SAID PERSONS HEREBY AGREE TO GUARANTEE AND BE HELD PERSONALLY LIABLE FOR ALL AMOUNTS DUE TO PENINSULAR PAPER COMPANY, INC., PRESENTLY OR IN THE FUTURE; THIS IS A PERMANENT AND CONTINUING PERSONAL GUARANTY IN FAVOR OF AND FOR THE BENEFIT OF PENINSULAR PAPER COMPANY, INC., ITS SUCCESSORS AND ASSIGNS. THE PERSONS SIGNING THIS AGREEMENT FURTHER AGREE THAT PENINSULAR PAPER COMPANY, INC. IS AUTHORIZED TO CHECK THEIR PERSONAL CREDIT, OBTAIN PERSONAL CREDIT REPORTS, AND ANSWER QUESTIONS ABOUT CREDIT EXPERIENCE WITH THEM AND OR THEIR COMPANY. THE WORD “APPLICANT” AS USED HEREIN SHALL REFER TO THE NAME OF THE CORPORATION, PARTNERSHIP OR PROPRIETORSHIP APPLYING FOR CREDIT HEREON, AS WELL AS TO ALL PERSONS SIGNING THIS CREDIT APPLICATION.
BY: ________________________________________ (SIGNATURE) TITLE: _______________________________
D.O.B.________________
BY: ________________________________________ (SIGNATURE) TITLE: _______________________________
_________________________________________ (PRINT NAME) SSN ______________________
_________________________________________ (PRINT NAME)
D.O.B.________________
SSN ______________________
TRADE NAME: ____________________________________________________________________________________ WITNESS: _____________________________________________
DATE: __________________________________
• IF A CORPORATION, AT LEAST ONE CORPORATE OFFICER MUST SIGN APPLICATION. • IF A PARTNERSHIP, TWO OR MORE PARTNERS MUST SIGN. ____________________________________________________________________________________________________ ____________________________________________________________________________________________________
(FOR OFFICE USE ONLY)
CREDIT TERMS APPROVED: ______________________
BY: _____________________________________
DATE: __________________________________________
SALESMAN ID# __________________________
WELCOME LETTER SENT: ________________________