15712 SW 41st Street, Suite 800
Fort Lauderdale, FL 33331 USA
Tel: (954) 202-7336
Fax: (954) 202-7337
CREDIT APPLICATION
Company Information: Date of Application______
Full Legal Business Name & d/b/a ______
Business Address______
City______State/Country______Postal Code______
Telephone ______Fax ______E-mail ______
Billing Address (If different) ______
City______State/Country______Postal Code______
Telephone ______Fax ______E-mail ______
Accounts Payable Contact: ______E-mail ______
Sole Proprietorship Partnership Corporation - Fed. Tax ID#______
(if applicable)
DUNS # ______Years in Business ______Resale # ______
(if applicable)
Credit Limit Requested ______Terms Requested ______
Preferred Vendors ______
Owner/Partner/Principal Information:
Owner Partner PrincipalName ______
(Check one)Title
Address______City______State/Country______Postal Code______
Phone______Social Security # ______Date of Birth ______
(Or other ID such as Driver’s License)
Owner Partner PrincipalName ______
(Check one)Title
Address______City______State/Country______Postal Code______
Phone______Social Security # ______Date of Birth ______
(Or other ID such as Driver’s License)
Business/Trade References:
PLEASE PROVIDE AT LEAST FOUR TRADE REFERENCES & FAX OR EMAIL INFO
Name ______Account # ______
Address______City/State/Country ______Postal Code______
Telephone ______Fax ______E-mail ______
Name ______Account # ______
Address______City/State/Country ______Postal Code______
Telephone ______Fax ______E-mail ______
Name ______Account # ______
Address______City/State/Country ______Postal Code______
Telephone ______Fax ______E-mail ______
Name ______Account # ______
Address______City/State/Country ______Postal Code______
Telephone ______Fax ______E-mail ______
Banking Information:
Bank Name ______Account # ______
Name/Title Check Signer ______Bank Officer______
Telephone ______Fax ______E-mail ______
BANK AUTHORIZATION
For the purpose of establishing an open credit account with Greenfield World Trade, we hereby authorize
you to release information on our checking account number ______
COMPANY ______SIGNED ______DATE ___/____/____
(authorized signer)
CREDIT AGREEMENT/GUARANTY
Full Legal Business Name, d/b/a: ______
TERMS OF AGREEMENT
This agreement shall apply to future credit (if any) and to existing indebtedness owed by undersigned to Greenfield WorldTrade, Inc. Greenfield WorldTrade is hereby authorized to make inquiry of our bank or trade references now and in the future to evaluate and update our credit worthiness. We agree to abide by the credit terms of Greenfield WorldTrade as established and amended from time to time. In the event, we do not comply with those terms, we agree to pay, in addition to the principal debt, interest at 18% per annum, plus all costs of suit. In the event a lawsuit is commenced, we agree that such suit take place in Broward County, Florida, at the option of Greenfield WorldTrade, and specifically waive the right to litigate outside Broward County. In the event that we sell, transfer or change the ownership or legal structure of our business, we agree to provide written notice thereof delivered to the credit department of Greenfield WorldTrade, which notice must be actually received. Until we provide such notice, we agree to be liable for all purchases made on the account(s) established in our name.
BY: ______Date _____/____/____
Owner Partner Principal Title
If a SOLE PROPRIETOR/PARTNERSHIP the following must ALSO BE SIGNED:
The undersigned, having a financial or other interest in the above named business, does unconditionally, personally and individually guaranty payment of all amounts owed to Greenfield WorldTrade by the above named business within credit terms granted, including interests, costs and attorney fees. I/We specifically agree to the venue provisions set forth above. This guaranty shall be continuing and may not be cancelled except by written notice actually received by the credit department at Greenfield WorldTrade.
______Date ___/___/___
Signature of Guarantor Printed Name of Guarantor
______Date ___/___/___
Signature of Guarantor Printed Name of Guarantor
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