Fox Lumber Sales, Inc. Credit Application | Salesperson:_______ | ||||||||||||||||||||||
#2 Riverbend Court, P.O. Box 1000, Hamilton, Montana 59840 - Phone: (406)363-5140 Fax: (406)363-6774 | |||||||||||||||||||||||
Corporate Applicants: | |||||||||||||||||||||||
Full Legal Name: __________________________ | Place of Incorporation: _____________________________ | ||||||||||||||||||||||
Officers: | Fed I.D.#: _______________________________________ | ||||||||||||||||||||||
President: ________________________________ | Secretary: ______________________________________ | ||||||||||||||||||||||
Vice-President: ____________________________ | Treasurer: ______________________________________ | ||||||||||||||||||||||
Other: ___________________________________ | Other: _________________________________________ | ||||||||||||||||||||||
Mailing Address: | Ship-to Address: | ||||||||||||||||||||||
P.O. Box: ____________ | City: ______________ | Street: _________________ | City: ______________ | ||||||||||||||||||||
Street: ______________ | State: _____________ | Street: _________________ | State: _____________ | ||||||||||||||||||||
Street: ______________ | Zip: _______________ | Other: _________________ | Zip: _______________ | ||||||||||||||||||||
Individual Applicants (include all owners) | |||||||||||||||||||||||
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All Applicants: | |||||||||||||||||||||||
Phone: _____________ | Fax: _________________ | Web Site: _______________ | Email: _______________ | ||||||||||||||||||||
Bank: ______________ | Address: ______________ | Account: _______________ | Phone: _______________ | ||||||||||||||||||||
_____________________ | Contact: _______________ | Fax: _________________ | |||||||||||||||||||||
Other Business Names: | _____________________ | _____________________ | _____________________ | ||||||||||||||||||||
Is Applicant? yes no | Check if Applicable: | Subsidiary of another business___ | Related to another business___ | ||||||||||||||||||||
Explain: _______________________________________________________________________________________ | |||||||||||||||||||||||
__________________________________________________________________________________ | |||||||||||||||||||||||
Purchasing Agent: __________________________ | Payables Contact: ______________________________ | ||||||||||||||||||||||
Phone: _____________ | Fax: _________________ | Phone: _________________ | Fax: _________________ | ||||||||||||||||||||
Type of Business: ____________________________________________________ | Year Established: _______ | ||||||||||||||||||||||
Trade Credit References: | |||||||||||||||||||||||
Name: _____________ | Address: ____________________ | Phone: ________________ | Act.#: _________________ | ||||||||||||||||||||
_____________________________ | Fax: __________________ | Limit: $ _______________ | |||||||||||||||||||||
Name: _____________ | Address: ____________________ | Phone: ________________ | Act.#: _________________ | ||||||||||||||||||||
_____________________________ | Fax: __________________ | Limit: $ _______________ | |||||||||||||||||||||
Name: _____________ | Address: ____________________ | Phone: ________________ | Act.#: _________________ | ||||||||||||||||||||
_____________________________ | Fax: __________________ | Limit: $ _______________ | |||||||||||||||||||||
Important: Read and Sign | |||||||||||||||||||||||
The undersigned certifies that the above information is true and accurate; gives Fox Lumber Sales, Inc. authority to conduct a credit inquiry; and binds applicant to abide by any credit and payment terms extended to applicant. Applicant further agrees to pay all collection charges, including attorney fees and costs; and grants to Fox Lumber Sales, Inc. a security interest in all goods it provides until paid in full. | |||||||||||||||||||||||
Authorized Signature ____________________________________________________________________________ | |||||||||||||||||||||||
Position: _______________________________________ | Date: _______________________________________ | ||||||||||||||||||||||
Personal Guarantee: | |||||||||||||||||||||||
In consideration for any credit extended, I hereby absolutely and unconditionally guarantee the full payment of all indebtedness to Fox Lumber Sales, Inc. whether by acceleration or otherwise, that applicant has or may incur, by reason of any goods purchased by applicant. | |||||||||||||||||||||||
Signature: _______________________________________ | Date: _______________________________________ | ||||||||||||||||||||||
Signature: _______________________________________ | Date: _______________________________________ | ||||||||||||||||||||||
1. Print a copy of this page. 2. Complete the form, sign and date it. 3. Fax the completed form to (406) 363-6774. |