Credit Application

Company Information

Company Name:  

Phone: 

Address:  

Fax: 

City:  

State: 

Zip:  

Type of Organization: 

  Corporation       Partnership      Proprietorship


Principals

1) Name:  

Title:  

2) Name:  

Title:  

3) Name:  

Title:  

4) Name:  

Title:  

Type of Business: 

Year Established: 

Federal Taxpayer
Identification: 

Sales Tax
Resale Number: 

Names of Persons Authorized to Charge Account: 

 

Trade References

1) Company: 

Contact: 

Phone: 

Address: 

City: 

State: 

Zip: 

2) Company: 

Contact: 

Phone: 

Address: 

City: 

State: 

Zip: 

3) Company: 

Contact: 

Phone: 

Address: 

City: 

State: 

Zip: 

4) Company: 

Contact: 

Phone: 

Address: 

City: 

State: 

Zip: 


Bank References


Bank: 

Contact: 

Phone: 

Address: 

City: 

State: 

Zip: 

Account No:

Account Type: 


Does applicant have any lawsuits, foreclosures, arrangements with creditors, or bankruptcy proceeding pending?  Yes:   No:
If yes, please explain. 

Has applicant given a UCC Financing Statement or Security Agreement to any creditor? Yes:   No:
If yes, please explain. 


 
The foregoing information is submitted for the purpose of obtaining credit for the purchase of merchandise on an open account and applicant warrants that the information is true and correct.

APPLICANTS AGREEMENT: 

The applicant, if credit is extended, does hereby agree to the following:
  1. To furnish CREDITOR, as requested, with information regarding the applicants financial condition, including but not limited to current financial statements:
  2. Upon request, execute a Creditor’s Financing Statement and/or other security agreements including promissory notes as provided under  the applicable Uniform Commercial Code.
I/We agree to make payments to Stockton Products promptly when due and do understand that the charges each month are due and payable according to the terms as stated on the invoice, becoming delinquent if not so paid, and shall then bear interest at 1.5% per month (18% per annum).

In the event it becomes necessary in the opinion of Stockton Products to file suit or engage the services of a collection agency or attorney to effect collection, I/We agree to bear all such expenses incurred, including but not limited to attorney’s fees, court costs, and interest.


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