CREDIT APPLICATION INDUSTRIAL HARDWARE IDAHO 115 EAST 48TH STREET BOISE, IDAHO 83714 PH: 208-375-5534 FX: 208-375-5582 SALES: Accounting:
Company Name: Phone:
Mailing Address: Fax:
City: State: Zip:
Job Site/ Delivery Address:
Email Address:
How would you like to receive you’re involves; Email: Fax: US Mail:
Are you Tax Exempt? If YES, sign the “STATE SALES TAX EXEMPTION CERTICATE”
Name: Permit #:
CERTIFICATE OF PURCHASE FOR RESALE
As provided by Idaho Sales Tax Act
I certify that I am a retailer of tangible personal property that the tangible personal property purchased by me from the above vendor is for resale or rental. If I use or consume any tangible personal property which I purchased tax free for resale or rental, I will report and pay sales tax on my cost thereof direct to the Tax Collector of the State of Idaho on my sales tax return.
Do you use/require purchase orders?
Purchasing Agent:
Nature of Business:
How long have you been in business?
Sole Ownership Partnership Corporation
List Owners, Partners/ or Officers:
Name: City: State: Phone:
Name: City: State: Phone:
Name: City: State: Phone:
Trade References (3 required minimum)
Name: City: State: Phone:
Name: City: State: Phone:
Name: City: State: Phone:
Bank: City: State: Phone:
Account: Branch:
I have made the above statements for the purpose of obtaining credit, and I hereby certify that they are true. I understand that the terms of sale for goods purchased on open account are as follows; it is agreed that payment will be made no later than thirty (30) days from the date sale on invoice. Service charge at the rate of 1 ½% per month (18% per year) will be added on all past due accounts. If collection becomes necessary, purchaser will pay court cost, collection costs and reasonable attorney fees. Signature of Principal(s) below signifies personal guarantee for partnership or corporate indebtedness.
Date: Signed by: Title: