EARTH SUN MOON PRINTWORKS
APPLICATION FOR CREDIT
Business Name: ______Bus. Phone: ______
DBA: ______Fax No.:______
Billing Address: ______Resale No. : ______
City:______State:______Zip: ______Email:______
LIST NAME(S) AND TITLE(S) OF CORPORATE OFFICERS, PARTNERS, OR OWNERS
Name/Title Home Address/Zip Code
1. ______
2. ______
BUSINESS INFORMATION
Business Start Date: ______No. Years at Present Address: ______
Entity (circle): Sole Proprietorship Partnership Corporation “S” Corporation Non-Profit Other: ______
Type of Business:______Credit Line Requested: ______
Accounts Payable Contact:______AP Phone No.: ______
Accounts Payable Email: ______Do you wish to receive invoices electronically? □ Yes □ No
TRADE REFERENCES
Name Account # Phone Credit Dept. Fax
1. ______
2. ______
3. ______
4. ______
BANK REFERENCE
Name/Branch Address/Zip Code Acct # Acct Type
1. ______
Individual at Bank Whom We May Contact ______Contact Phone: ______
PAYMENT TERMS – 1% 10, NET 30
A late charge of 1.5% per month (18% per annum) will be charged on delinquent balances.
Failure to pay within terms may result in loss of credit terms.
I certify that all the information on this application is correct and that I fully understand your credit terms and agree to the proper payment in consideration of credit extended. I authorize Earth Sun Moon Trading Company, LLC. to contact all references listed on this form for the sole purpose of obtaining information to assist them in determining my creditworthiness.
This agreement includes the terms and conditions titled “Earth Sun Moon Terms” below.
The undersigned, if not an authorized officer/agent of the company, personally guarantees the repayment of any and all debt.
X______
SIGNATURE TITLE
EARTH SUN MOON TERMS
· Both parties agree that a facsimile copy of this document will be considered to be an original.
· A $30 fee will be charged for all checks returned for non-sufficient funds or any other reason.
· In the event of a breach of any of the terms of this agreement between Purchaser and Supplier, including but not expressly limited to the failure to pay sums owed to the Supplier when due, the Purchaser agrees to pay the reasonable attorney fees incurred by the Supplier in the enforcement of Supplier’s rights even though no suit or action is filed. In the event that suit is brought to enforce any part of the terms of sale herein, venue will be in Mercer County, Pennsylvania.
FAX APPLICATION BACK TO 724-605-2983 OR MAIL TO 111 NORTH CENTER STREET, GROVE CITY, PA 16127 ATTN: CREDIT DEPT.