Credit Application

Transcription

Credit Application
NETVOC Communication LLC
2 Ilene Court
Building 1 Unit 7
Hillsborough, NJ 08844.
Tel/Fax: +1-908-418-4398
Email: [email protected]
CREDIT AGREEMENT
1. Your Sales Tax Certificate must accompany this application
2. For Terms your audited Financial Statements (Balance Sheet and Income
Statements) or signed Financial statements
(Signed by the owners / Partners / Officers) must accompany this application.
NOTE: Failure to comply with all the sections of this application can delay
credit approval.
Accounts Payable Contact:
A/P Email:
Accounts Telephone Number :
A/P Fax Number:
ORGANIZATIONAL DATA
Company name:
Phone:
Fax:
E-mail:
Registered company address:
City:
State:
ZIP Code:
Incorporation Date & State
Length of Time in Business Under Current Name
Name of Parent Company
Date business Established:
D&B Number:
Sole proprietorship:
Partnership:
Corporation:
Other:
ANNUAL SALES VOLUME – Check One
__ $100,000 – $250,000
__ $250,000 - $500,000
__ $501,000 – 10,00,000
__ $10,00,000+
__ $50,00,000+
TYPE OF TERMS REQUESTED – Check One
__ COD Company Check
No. of Employees :
__ Use Credit
Card
__ Net Terms
__ Credit Line Desired
Does Parent Company Guarantee Debts?:
Office Names / Titles – (For Partnerships or Individual Owners Complete Entire Section)
Name & Title:
Address:
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City:
State:
ZIP Code:
Social Security Number
Drivers License #:
State:
Name & Title:
Address:
City:
State:
ZIP Code:
Social Security Number
Drivers License Number
State:
TRADE REFERENCES
Phone
Number:
Name:
Fax:
Account Number:
Address:
Phone
Number:
Name:
Fax:
Account Number:
Address:
BANK INFORMATION
Bank name:
Address:
Phone:
City:
State:
Fax:
ZIP Code:
Checking#:
Savings#:
Loan#:
Bank name:
Address:
Phone:
City:
State:
Fax:
ZIP Code:
Checking#:
Savings#:
Loan#:
PLEASE ACCEPT THIS AS YOUR AUTHORIZATION TO RELEASE CONFIDENTIAL INFORMATION TO NETVOC
Communication LLC.
AUTHORISED SIGNATURE:
COMPANY:
Printed Name:
Title:
Date:
AGREEMENT
*(PLEASE SIGN BELOWIN ORDER FOR THIS AGREEMENT TO PROCEED)
The company making this application (hereafter known as Buyer) in order to induce NETVOC Communication LLC,
to sell to Buyer, agrees to the following terms. NETVOC Communication LLC retains and buyer grants a purchase
money security interest in all products and the proceeds thereof sold by NETVOC Communication LLC to Buyer,
until satisfied in full, all of its obligations to NETVOC Communication LLC. Buyer shall execute such financing
statements as reasonably requested by NETVOC Communication LLC. Buyer hereby represents and warrants that
it is solvent, and Buyer furthermore warrants that it will pay its obligations to NETVOC Communication LLC
(according to NETVOC Communication LLC invoice due date and amount shown), as they come due and that
Buyer’s liabilities do not exceed its assets. Buyer agrees to pay interest on all amounts that are past due. Interest
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charged by NETVOC Communication LLC, will be 1.5% per month or the highest rate allowed by law. This
representation, warranty, and these terms, shall be in effect with each purchase obligation, whether by written or
Verbal Purchase Order, or by procurement of product from NETVOC Communication LLC by agreement, until the
Buyer and NETVOC Communication LLC agree in writing to change this. All costs of collection, including
reasonable attorney’s fees and court costs, shall be paid by Buyer regardless whether suit is filed or not. The
undersigned authorized officer of Buyer certifies that all the information contained in the application and its
attachments are true and correct to the best of their information, knowledge, and belief. Buyer hereby agrees to
adhere to policies and procedures as well as all terms and conditions established by NETVOC Communication LLC
and published by NETVOC Communication LLC. The signature below acts as authority to release credit
information by phone or by letter to the companies approached for credit information to NETVOC Communication
LLC.
SIGNATURES
Title:
Date:
Title:
Date:
RESALE CERTIFICATE
(PLEASE FILL IN AND SIGN THE BELOW OR FAX A COPY OF RESALE CERTIFICATE)
Firm Name:
I hereby certify that I hold valid seller’s permit No. __________issued by the state of ______________pursuant
to the Sales and Use Tax Law; that I am engaged in the business of selling_______________________________
The tangible personal property described herein, which I purchase from NETVOC Communication LLC, will be
resold by me in the form of tangible personal property: and that in the event any such property is used for any
purpose other than retention, demonstration, or display while holding it for sale in the regular course of business,
it is understood that I am required by State Sales and Use Tax Law to report and pay for the tax. measured by
the purchase price of such property.
SIGNATURES
Title:
Date:
Title:
Date:
INDIVIDUAL PERSONAL GUARANTEE
(PLEASE FILL IN AND SIGN THE BELOW OR FAX A COPY OF RESALE CERTIFICATE)
I ______________________________________residing at for good and Valuable consideration, including the
extension of credit which I hereby acknowledge as having been received, do hereby personally guarantee and
promise to pay any obligation to NETVOC Communication LLC on demand for any indebtedness of to NETVOC
Communication LLC which may become due. This guarantee shall be a continuing and irrevocable guarantee and
indemnity to NETVOC Communication LLC. Further. I hereby subrogate any indebtedness of which it may have to
me to the indebtedness of NETVOC Communication LLC. I do hereby waive notice of default, non-payment and
notice thereof and to jury trial and consent to all renewals and modifications of credit. Interest charged by
NETVOC Communication LLC will be 1.5% per month or the highest rate allowed by law. All costs of collection.
including reasonable attorney‘s fees and court costs, shall be paid by Buyer regardless whether suite is filed or
not.
Signature ________________________
Social Security ________________________ Date __________________________
Witness Signature ___________________ Printed Witness Name _________________ Date __________________________
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