Credit Application Commercial (Page 2 of 4) in pdf

COMMERCIAL

FOR DIAMOND VOGEL USE ONLY

Business Account

Store Location _______________________________

CREDIT APPLICATION

Store No.__________ Customer No.______________

IMPORTANT: COMPLETE ALL INFORMATION to speed your

Salesperson ______________ Date ______________

application review time.

BUSINESS NAME

OR D/B/A “DOING BUSINESS AS”

MAILING ADDRESS

SHIPPING ADDRESS

Address

P.O. Box

Address

City

State

Zip Code

City

State

Zip Code

PHONE NO.

FAX NO. /E-MAIL

Phone ___________________________

Fax ___________________________________

Cell ______________________________

e-Mail _________________________________

TYPE OF OWNERSHIP

LINE OF BUSINESS

PRODUCT MFG?

Sole Proprietor

Partnership

Corporation

Other ____________

Yes

FEDERAL TAX I.D. NO.

SALES TAX EXEMPT?

NUMBER OF YEARS IN BUSINESS?

NUMBER OF YEARS AT PRESENT ADDRESS?

Note: If exempt from sales tax,

attach a copy of sales tax exempt

certificate.

ANNUAL PAINT PURCHASE ESTIMATE

ESTIMATE MONTHLY CREDIT NEEDS

Dollars $ ___________

Are purchase orders required?

Yes

Low Month $ ____________

High Month $ _____________

OWNERS AND/OR PRINCIPALS

Name

Social Security

Spouse’s Name

Social Security

Spouse’s Name

Social Security

Spouse’s Name

Address

City

State

Zip Code

City

State

Zip Code

City

State

Zip Code

OWNERS AND/OR PRINCIPALS

TYPE OF BANK ACCOUNTS

Checking

Loan

Savings

Name of Bank

Phone

Fax

Account Number

$ _______________

Address

City

State

Zip Code

Name of Loan Officer

Loan Balance

PAINT SUPPLIER REFERENCES

OTHER CREDIT REFERENCES

Name _______________________________________________________________

Address ______________________________________________________________

City ____________________________ State _________ Zip Code ______________

Phone No. ______________________

Fax No. _____________________________

Phone No. ______________________

Fax No. _____________________________

Name _______________________________________________________________

Address ______________________________________________________________

City ____________________________ State _________ Zip Code ______________

Phone No. ______________________

Fax No. _____________________________

Phone No. ______________________

Fax No. _____________________________

In the event that the credit applied for is granted, I (we) agree to keep my account below the credit limit you assign to my account and pay to all charges within 30 days. I (we) agree to pay 1½% (.50

minimum) finance charges per month (18% Annual) on the amount that may become past due on my account. I (we) further agree to indemnify and hold “DIAMOND VOGEL” harmless against all expenses, loss

damage or injury , including reasonable attorneys fees incurred in collection in the above obligation. I (we) further agree that “DIAMOND VOGEL” may contact any source necessary to determine my (our) credit

and financial responsibility, now or at any time in the future, as it deems necessary.

THE ABOVE INFORMATION IS TRUE AND CORRECT AND I HAVE RECEIVED A COPY.

A FAXED APPLICATION WILL BE DEEMED AS THE ORIGINAL TO EACH CREDIT APPLICATION

DATE

AUTHORIZED SIGNATURE

TITLE

FOR DIAMOND VOGEL USE ONLY

DATE

PARTNER/CO-APPLICANT SIGNATURE

TITLE

Date Investigated

Approved By