Commercial Credit Application printable pdf download

Parks Building Supply

2141 Owen Drive

Fayetteville, NC 28306

910-483-8194

Fax 910-483-8197

COMMERCIAL CREDIT APPLICATION

Company and/or Customer Name: _________________________________________________________________________________________

 Proprietorship

 Partnership

 Corporation

 LLC



Legal Status:

LLP

Purchase Orders Required?  Yes  No

Est. Monthly Purchases: _________________________

Contact Person: ______________________________

Federal Tax ID: __________________________

 Yes

 No

Licensed Contractor:

License #:

State: ______________

 Residential

 Commercial

Other (Specify): _______________________

 Yes

 No

Has the corporation, any of the principals of the business or their spouses, ever filed for Bankruptcy?

If so, when: _______________

Under what name and in what court: ______________________________________________________

Date business started:

Date business incorporated: __________________________

Mail Invoices and Statements to:____________________________________________________________________________________

Address

City

State

Zip

Office Phone: ____________________________________________

Office Fax Number: ______________________________________

Physical Address: ________________________________________________________________________________________________

Address

City

State

Zip

PRINCIPAL(S) INFORMATION:

Owner/Officer Name:

Officer Name: ___________________________________________

Title:

Title: __________________________________________________

Home Telephone:

Home Telephone: ________________________________________

Mobile Phone:

Mobile Phone: ___________________________________________

Soc. Sec. #:

Soc. Sec. #: _____________________________________________

E-Mail:

E-Mail: ________________________________________________

If additional space is needed to list principals, please attach another sheet of paper.

Bank/Trade References

Address

Account #

Phone

Fax

1. _____________________________________________________________________________________________________________________

2. _____________________________________________________________________________________________________________________

3. _____________________________________________________________________________________________________________________

4. _____________________________________________________________________________________________________________________

CREDIT TERMS & CONDITIONS

Unless otherwise stated in writing, credit terms are Net 15

Parks Building Supply Company (“Parks”) and persons signing below (“applicant” or “guarantor”), also collectively referred to as “I/we”, hereby

agree as follows:

Parks may impose a finance charge or late charge in the event of late payment. In this event, applicant agrees to pay a one and one-half

percent (1½%) late charge per month on all past due balances. This is a maximum A.P.R. of eighteen percent (18%). In conformity with N.C.G.S.

§24-5, the aforementioned rate also applies after judgment. Applicant agrees to pay all collection costs incurred by Parks in enforcement of the terms

and conditions of this agreement, including court costs, reasonable attorney's fees, and collection agency fees

Failure by Parks to levy a finance or

(CONTINUED ON REVERSE) ______ (initials)

______ (initials)

Commercial Credit Application

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