EPS ORGANICS

Credit Application for a Business Account

Business Contact Information
Federal ID No./SSN: Principal owner/Officer:
Company name:
Phone: / Fax: / E-mail:
Registered company address:
City: / State: / ZIP Code:
Date business commenced:
Sole proprietorship: / Partnership: / Corporation: / Other:
Business and Credit Information
Primary business address:
City: / State: / ZIP Code:
Are purchase orders required? Credit Limit Requested:
Telephone: / Fax: / E-mail:
Bank name:
Bank address: / Phone:
City: / State: / ZIP Code:
Type of account / Account number
Savings
Checking
Other
Business/trade references
Company name:
Address:
City: / State: / ZIP Code:
Phone: / Fax: / E-mail:
Type of account:
Company name:
Address:
City: / State: / ZIP Code:
Phone: / Fax: / E-mail:
Type of account:
Company name:
Address:
City: / State: / ZIP Code:
Phone: / Fax: / E-mail:
Type of account:
Agreement
1.  All invoices are to be paid 30 days from the date of the invoice. All invoices not paid within terms will be assessed a finance charge of 1.5% per month (18% annual percentage rate).
2.  Claims arising from invoices must be made within seven working days.
3.  In the event it should become necessary to place this account for collection, you agree to pay all collection costs and expenses, including but not limited to attorneys fees and court costs.
4.  By submitting this application, you authorize EPS ORGANICS to make inquiries into the banking and business/trade references that you have supplied.
Signatures
Title:
Date: / Title:
Date:

In consideration of the extension of credit, I hereby grant to EPS Organics a continuing guarantee payment of all indebtedness, including interest, collection costs, and expenses as stated on the application.

______

Individually

Please submit your completed and signed application by mail to: EPS Organics, 1 South Drive, Miami Springs, Fl. 33166 or by fax to: (305)887-0640.