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123 Street Avenue, City Town, 99999

(123) 555-6789

email@address.com

 

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Credit Application

Credit application

Shipping Address *
Shipping Address
Billing Address *
Billing Address
Owner Principle *
Owner Principle
Home Address *
Home Address

Personal Guarantee

By signing below, the applicant:

1. All invoices will be paid according to your stated terms.

2. We/I will pay late payment finance charges which are computed by a periodic rate 1 2/3% per month, which is an ANNUAL PERCENTAGE RATE of 20% applied to past due balances.

3. We/I agree to notify you immediately of any change of ownership.

4. If this account is placed for collection, we/I agree to pay all reasonable charges including attorney’s fee and further agree that a charge of 20% of the amount of the claim shall be considered reasonable as a fee.

I hereby certify that the information contained herein is complete and accurate. This information has been furnished with the understanding that it is to be used to determine the amount and conditions of credit to be extended. Furthermore, I hereby authorize the financial institutions listed in the credit application to release any necessary information to the company for which credit is being applied for in order to verify the information contained herein. I hereby personally guarantee payment of any and all obligations incurred and agree to personally pay the said obligations, in accordance with the terms between parties, in the event of default.

Authorized Signature____________________________________________________________________________

Print Name_____________________________________________________ Title_________________________________________________________ Date__________________________________

*Complete page 2 if credit terms needed, if not cash or check is required at time of delivery*