7230
Springboro Pike
Phone:
439-0504 Fax: 439-5757
APPLICATION
FOR CREDIT
Page 1 of 2
BILLING ADDRESS:
_______________________________________________________
SHIPPING ADRESS:
_______________________________________________________
CITY/STATE/ZIP:
_________________________________________________________
PHONE:
_____________________________ FAX: ______________________________
FEDERAL I.D.# ___________________________ YEARS IN BUSINESS: __________
Proprietorship _________
Partnership __________ Corporation __________
Authorized Purchasers:
____________________________________________________
Accounts Payable Manager:
_________________________________________________
List three references with
which you have had an account with for at least one year.
1.
Company Name: _________________________________ Telephone: ______________
Address:
________________________________________ Fax #: _________________
________________________________________ Account #: ______________
2.
Company Name: _________________________________ Telephone: ______________
Address:
________________________________________ Fax #: _________________
________________________________________ Account #: ______________
3.
Company Name: _________________________________ Telephone: ______________
Address:
________________________________________ Fax #: _________________
________________________________________ Account #: ______________
7230
Springboro Pike
Phone:
439-0504 Fax: 439-5757
APPLICATION
FOR CREDIT
Page 2 of 2
____
P.O. Number ____ Department
Number ____ Job Number ____ Job Name
If
you have a list of authorized signers for this account, please include the list
with this application. In the event the list should change, applicant is
responsible to provide an updated list to Do It Yourself Rental.
Collection Costs, Attorney
Fees and Interest Rate:
The
undersigned understands and agrees to terms of sale and further agrees to pay
all collection costs and attorney’s fees necessary to collect past due accounts
as permitted by law and interest at the monthly rate of 2% (24% annually) on
all past due balances.
Name:
____________________________ Title: _________________ Date: ___________
Personal
Guarantee:
The
undersigned acknowledges extended credit to persons or company above. The undersigned agrees to personally,
individually and unconditionally guarantee the full, prompt and complete
payment of all indebtedness of every kind and nature owing to Do It Yourself
Rental by the above named persons or company.
The undersigned further agrees to pay all collection costs, including
but not limited to, court costs, attorney fees, and filing fees as permitted by
law.
Name:
____________________________ Title: _________________ Date: ___________