Fox Lumber Sales, Inc.             Credit Application                Salesperson:_____

#25 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: ___________________________________ 

State Resale Cert. No: _____________________ 

(If left empty State sales tax will be added to all sales)

Mailing Address:

Ship-to Address:

P.O. Box:___________ 

City: ______________

Street: _________________

Street:______________

State: _____________

Street: _________________

Street:______________

Zip: _______________

Other: _________________

Individual Applicants (include all owners)

All Applicants:

Phone:____________

Fax: _________________

Web Site: _______________

Bank:_____________

Address: ______________

Account: _______________

_____________________

Contact: _______________

Other Business Names:

_____________________

_____________________

Is Applicant?  yes  no

Check if Applicable:

Subsidiary of another business___

Explain: ________________________________________________________________________________

Purchasing Agent: __________________________

Payables Contact:_________________________

Phone:____________  

Fax: _________________

Phone: _________________

Type of Business: ____________________________________________________

Trade Credit References:

Name: ____________

Address: ____________________

Phone: ________________

_____________________________

Fax: __________________

Name: _____________

Address: ____________________

Phone: ________________

_____________________________

Fax: __________________

Name: _____________

Address: ____________________

Phone: ________________

_____________________________

Fax: __________________

Important: Read and Sign

The undersigned certifies that the above information is true and accurate; gives Fox Dispatch and its affiliates (herein Fox) 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 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 whether by acceleration or otherwise, that applicant has or may incur, by reason of any goods purchased by applicant.

Signature: _______________________________________

Date: ____________________________

Print Name, Title__________________________________