DS&J Enterprises, Inc.
dba Arizona Commercial Lighting & supply
1436 E. 17th Street
Tucson, AZ 85719
520-322-9611
Fax : 322-9580
CREDIT APPLICATION
FOR THE PURPOSE OF PROCURING AND ESTABLISHING CREDIT FROM ARIZONA COMMERCIAL LIGHTING, THE UNDERSIGNED APPLICANT FURNISHES THE BELOW INFORMATION AND THE ATTACHED FINANCIAL STATEMENT AND HEREBY WARRANTS THE SAID INFORMATION IS A TRUE, CORRECT, AND COMPLETE STATEMENT OF IT’S FINANCIAL CONDITION.
FAILURE TO COMPLETE THIS APPLICATION MAY CAUSE A DELAY IN PROCESSING ORDERS
Company Name: ______Telephone#: ______
Street Address: ______P.O. Box ______Fax#: ______
City/State/Zip: ______Credit Limit Requested______
Type of business : ______Date Established ______
[ ] Sole proprietorship [ ] Partnership [ ] Corporation
Company Officers:
President : ______Telephone # ______
Credit Manager: ______Telephone # ______
Name of Purchasing Agent : ______Telephone # ______
Financial Information :
Name of Bank ______ Telephone # ______
Account Number : ______Contact Name : ______
Credit and Trade References :
Name / Address: Fax # Phone # Contact
______ _______
______
______
______ ______
Does applicant have a potential shipment within 15 days from the application date? Yes [ ] No [ ]
Amount $______
Has a tax lien or civil suit ever been filed against applicant or any of it’s owners, or principals? Yes [ ] No [ ]
Has applicant or any of it’s owners, or principals ever filed voluntary petition in bankruptcy ? Yes [ ] No [ ]
Tax Status:
[ ] Taxable
*[ ] Resale # ______ Federal Tax I. D. # ______
* A CERTIFICATE OF EXEMPTION OR THE ATTACHED TAX CARD MUST ACOMPANY THIS APPLICATION.
AGREEMENTS, TERMS, AND CONDITIONS
In consideration of Arizona Commercial Lighting ( ACL) extending credit to Applicants, the Applicant agrees to pay for all items delivered to or at the request of applicant by (ACL) within 10 days from the date of the invoices for said items. All accounts are due and payable at the remittance address shown on the ACL invoice. Applicant agrees that each of the terms and conditions of the sale stated on the (ACL) invoices shall be a term of contract of each sale from ACL to have not been paid within 30 days of date of invoice and Applicant agrees to promptly pay said service charge. The service charge will be due and payable each month. Waiver of any one or more service charges shall not be deemed to be a waiver of future charges. Applicant concedes that any check made payable to ACL which is dishonered by the bank upon which it was drawn, will be charged a processing fee of 50.00 or 7%of the dishonored check, whichever is greater. The Applicant(s) are responsible for lost or damaged merchandise not reported within 15 days of delivery. All special order items are not returnable . Returns must be authorized and are subject to restocking charges. Applicant further agrees that Applicant and ACL are parties to a written contract. If ACL commences litigation, employs attorneys, or enlists commercial collection agents in order to secure payment of any sums due to it from Applicant, the Applicant agrees to processs, jurisdiction and venue of the courts of the State of Arizona , Pima County and to the process, jurisdiction and venue of the United States District Court for the State of Arizona, Pima County. The undersigned warrants that the above agreement has been carefully read and that the Applicant understands and agrees to the same.
Applicant aurthorizes ACL to obtain credit and financial information concerning the applicant at anytime and from any scource.
Exceuted at ______. On the______day of ______, 200 [ ]
Purchase order # required for payment? Yes [ ] No [ ] Name of Applicant ______
Signature/ Title ______
For value received and to induce ACL to exceed credit to extend credit to the Consumer (s) shown on the reverse side hereof, the Guarantor ( even if more than one ) hereby warrants and unconditionally guarantees to ACL the full and prompt payment when due ( including any accelerated or extended maturity ) of all indebtedness, obligatios, and libilities of Customer(s) to ACL, including finance charges applicable thereto, now existing or thereafter created or rising, even if such inebtedness is in excess of the applied for, or established credit line. Guarantor further agrees to pay all expenses, including expenses of court costs and attorney’s fees paid or inccured by ACL in endeavoring to collect such indebtedness of any part thereof or enforcing this Guarantty.
The incorporation, merger, reorganization or sale of the Customer’s business shall not operate as a termination of the Guaranty, and the guaranty shall continue as to credit extended such other entify.
This Guaranty shall continue in force until notice in writing of termination sent by registered or certified mail, return receipt requested, is received by ACL, Attention: Credit Manager. This notice is to specify the date on which the Guaranty is to be terminated, said date not to be less than seven (7) days after the described notice is received and shall not affect transactions with Customer entered into prior to the termination date.
This Guranty is enforceable against the undersigned Gurantors whether or not the signatures are witnesses .
______
Guarantor (without corporate title) Date Spouse of Guarantor (N/A if no Spouse) Date
______
Guarantor (without corporate title) Date Spouse of Guarantor (N/A if no Spouse) Date
______
Arizona Commercial Lighting Internal UseOnly
Approved : ______By: ______
Credit Limit ______Date: ______
Account # : ______
PRINTABLE APPLICATION ONLY!