20697 Fenway Avenue North

Forest Lake, Minnesota 55025

(651) 464-3900

Fax (651) 982-1299

NEW CUSTOMER PROFILE/CREDIT APPLICATION

Date ______

Legal Name ______

Other Names Used______

Street Address ______

Billing Address ______

Telephone Number______Fax Number ______

Parent Company______City ______State ______Zip ______

Federal Tax ID # ______Dunn & Bradstreet # ______

Year Business Started ______Type of Business ______

Annual Sales ______Number of Employees ______

Company Structure:

Corporation LLC Proprietorship Partnership

NAMES OF PRINCIPALS, OFFICERS, PARTNERS, OR OWNERS:

Name ______Title ______

Name ______Title ______

PURCHASING CONTACT:

Name ______Title ______Telephone ______

ACCOUNTS PAYABLE CONTACT:

Name______Title ______Telephone ______

HAVE WE EVER SOLD TO YOU BEFORE OR TO ANY PRESENT OR FORMER AFFILIATE?

Yes Or No

If Yes, Under What Name and When ______

ARE YOUR RECEIVABLES AND/OR INVENTORY PLEDGED TO OTHERS?

Yes Or No

If Yes, Please Explain: ______

______

TRADE REFERENCES:

(Complete addresses are necessary to expedite the application process)

1. Name ______

Telephone Number ______Fax Number ______

Street Address______City ______State ______Zip ______

2.Name ______

Telephone Number ______Fax Number ______

Street Address ______City ______State ______Zip ______

3. Name ______

Telephone Number ______Fax Number ______

Street Address ______City ______State ______Zip ______

BANK REFERENCE

Bank ______Branch ______

Street ______City ______State______Zip ______

Checking Account No. ______Loan Account No. ______

Contact ______Title ______Telephone Number ______

TERMS AND CONDITIONS

  1. The applicant hereby acknowledges that all charges after extending credit shall be considered due and payable thirty (30) days from date of invoice and those payments shall be made at this time to the order of Teamvantage Molding, LLC and forwarded to the designated address.
  1. The applicant hereby authorizes Teamvantage Molding, LLC to perform any credit investigation deemed necessary to establish and maintain a credit account for the applicant. The applicant hereby authorizes the reporting of the above-mentioned information to Teamvantage Molding, LLC, and Teamvantage Molding, LLC may modify or terminate any credit availability granted to the applicant.
  1. Teamvantage Molding, LLC may charge the maximum interest allowed by law on all overdue amounts.
  1. The applicant as a sole proprietor or partnership if applicable; hereby consents to Teamvantage Molding, LLC obtaining an individual credit report if necessary to extend trade credit.
  1. The applicant hereby consents to abide by all terms and conditions as set out on all invoices.
  1. Applicant agrees that if it defaults in payment in accordance with terms, it will pay all costs of collection including but not limited to collection agency fees, reasonable attorney fees, court costs, filing fees and service fees.

Company ______Title ______Date ______

Signed By ______Print Name ______