Fillable Credit Application Form printable pdf download

CREDIT APPLICATION

For your convenience, this form may be completed here and then printed. Please sign at the bottom.

BUSINESS NAME ______________________________________________ PHONE (___)____-________

ADDRESS ______________________________ CITY _____________________STATE ___ ZIP ________

E-MAIL ADDRESS ______________________________FAX (___)____-_______CELL (___)____-______

NATURE OF BUSINESS_________________________ CORP PARTNERSHIP PROP 

FEDERAL I.D. #____-____________ S.S.N. # _____-____-_______ START DATE (Year) ____________

TAX EXEMPT: NO  YES 

“If “YES”, please submit sales tax exemption certificate for your state”

REQUIRE P.O. YES  NO INVOICES ARE NOT MAILED. EMAILED  or FAXED  ONLY.

PROPERTY: OWNED  RENTED If Rented; Landlord ________________Phone(___)___-______

OWNERS NAME ___________________________________________ PHONE (____)______-__________

OWNERS ADDRESS ________________________ CITY ___________________ STATE __ ZIP ________

PRIMARY BANK__________________________ ADDRESS______________________________________

BANK CONTACT PERSON __________________ PHONE (___)____-_______ FAX (___)____-________

NAME THREE TRADE REFERENCES YOU CURRENTLY HAVE AN OPEN ACCOUNT WITH.

1. _______________________________________ PHONE (___)_____-________ FAX (___)_____-_______

2. _______________________________________ PHONE (___)_____-_________ FAX (___)____-_______

3. _______________________________________ PHONE (___)_____-_________ FAX (___)____-_______

CREDIT TERMS



All accounts are due & payable according to terms stated on your invoice copy.



Any account with a balance 90 days old will be placed on a C.O.D. basis



Charge privileges will be reviewed before credit is reinstated



Finance charges will be charged on all overdue balances at 1.5% per month, 18% per year



In the event credit is extended, the applicant agrees to pay all costs & expenses (including actual

& reasonable attorney fees) incurred by ABS in collection of any outstanding accounts.

I authorize the credit manager of Auto Body Specialties, Inc. to obtain a written or oral report necessary

for the purpose of decision on credit.

Signature________________________________________________ Date_________________________

(No application will be considered without a signature.)

Fax: 605-336-7641

Email to:

Credit Application Form