| Home | Services | Contact |
CONFIDENTIAL APPLICATION FOR BUSINESS CREDIT AND
ACKNOWLEDGEMENT OF TERMS
The Following information,
which the undersigned warrants to be true and correct, is submitted as a basis
for consideration of this
application D&H
Printing Inc. dba D&H Printing (hereinafter
“D&H Printing”), is authorized to investigate relationships with
creditors and all financial institutions for the purpose of
establishing credit.
|
Firm’s Legal Name |
Date |
||||
|
d/b/a |
Federal Tax Number |
||||
|
Firm’s Address |
City |
State |
Zip |
||
|
Ph |
Fax |
Branch Home Office |
#years in business |
Anticipate Vol |
|
|
Sales Tax: Non Exempt Exempt
(MUST attach certificate)
Purchase order required?
Y N |
|||||
|
Doing Business as a:
Corporation Partnership Limited Partnership LLC Member-Managed Sole Proprietor |
|||||
|
Accounts payable contact |
Title |
Phone |
Full names and home addresses
of officers, partners, or proprietor:
|
Name |
Title |
SS# |
|
|
Home Address |
City |
State |
Zip |
|
Name |
Title |
SS# |
|
|
Home Address |
City |
State |
Zip |
|
Name |
Title |
SS# |
|
|
Home Address |
City |
State |
Zip |
|
Has Applicant ever filed for
bankruptcy? Y N (If yes, please attach
explanation) |
|||
Major Trade & Banking
References:
|
Firm |
Address |
Account# |
Phone |
|
Firm |
Address |
Account# |
Phone |
|
Firm |
Address |
Account# |
Phone |
|
Firm |
Address |
Account# |
Phone |
NOTE: If a standard credit and/or
reference sheet is provided a complete application is still required to obtain
credit.
IF APPLICANT HAS TAX EXEMPT STATUS, A VALID SALES TAX
EXEMPTION CERTIFICATE OR RESALE CERTIFICATE
IS REQUIRED TO BE SUBMITTED WITH THIS APPLICATION.
Please attach a Current Financial Statement (Balance
Sheet and income statement) with your application. This will help to speed
the processing of your application for open credit terms.
All orders will be C.O.D. until credit is approved. The
applicant agrees the extension and maintenance of credit terms is at the sole
discretion of D&H
Printing.
The applicant shall notify
D&H Printing of any changes in name, address, ownership or legal entity. In
the event there is a change in
ownership or legal
entity all orders will be C.O.D. until credit is approved for the new owner or
entity.
Applicant agrees to the
following payment terms in the event credit is extended. All extensions of
credit on account are due and
payable according to
the terms stated on each invoice. Applicant acknowledges credit and payment
terms are subject to change
without notice.
Applicant agrees that in order
for D&H Printing Inc. to extend credit,
for any legal action
to enforce modify or clarify payment and terms of this agreement.
ACKNOWLEDGEMENT OF RESPONSIBILITY: SHOULD D&H PRINTING INC. EXTEND CREDIT TERMS TO
THE APPLICANT
, AND IN CONSIDERATION OF SUCH
CREDIT BEING EXTENDED, THE APPLICANT AGREES THAT IN THE EVENT
PAYMENT IS NOT MADE ACCORDING
TO THE PAYMENT TERMS ESTABLISHED BY D&H PRINTING INC. THE APPLICANT
SHALL PAY REASONABLE
ATTORNEY FEES AND COLLECTION COSTS TO COLLECT THE DEBT. ALL BEBTS PAST
DUE AS
ESTABLISHED BY INVOICE OR OTHER CREDIT SHALL
ACCRUE AT THE RATE OF 18% PER ANNUM OR THE MAXIMUM
LEGAL INTEREST RATE UNTIL PAID IN FULL.
Print or Type Name of
Applicant:
|
|
Signature of President,
Partner or other Authorized Principal Officer and Title:
|
Signature |
Title |
Date |
D&H Printing Use Only:
|
Account# |
Credit Line |
D&B |
Paydex |
Action/Comments |
Tax Status |
|
|
|
|
|
|
|
2772 W. Commerce St. *