Besco


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Application for Credit

Date

Firm Name

Type of Business

Street Address

City, State, Zip

Phone

Fax

Email
Required

Please Check one

Individual

Partnership

Corporation

For Individual account, the following must be completed:

Date of birth

Social Security

For Corporate account, the following must be completed:

Name of owners/officers

Home address

City

Zip code

Date Established

Federal ID #

Resale Certificate #

General Information

Credit Line Requested

Ship to Address

Purchasing Contact

Accounting Contact

Purchase Orders

Job names required

Trade References

Company´s Name	City, State	Fax #	Contact

Bank Reference

Name of Bank

Account #

Street Address

City

State

Zip Code

Phone #

Fax #

Contact Person

I have read & agree to all that info below

The applicant realizes that if Besco approves credit, he/she/the company would understand the following terms and conditions: 1) The undersigned (in his/her, individual capacity) as the principal of the Company seeking the extension of credit, realizes the importance and value of credit being extended to his/her business and as a result does personally guarantee payment for any credit extended to the company. 2) Terms are 2% 10th of month, net 30 days from date of invoice. 3) Accounts over sixty (60) days will be charged interest 11/2 % per month. 4) Credit privileges will be suspended on accounts that have exceeded their limits or accounts with balances sixty one days old. Exception to this requirement will be made only in those cases in which definite payment plans have been agreed upon through our credit department. 5) Applicant understands that in the event he/she defaults upon payment pursuant to the terms as set forth herein above, Besco is entitled to charge attorney´s fees incurred in its attempt to collect. We certify that all information on this application is correct, and that we fully understand your credit terms and agree to proper terms and agree to proper payment in consideration of extended credit. We hereby authorize you to investigate the references listed herein and consent to Besco´s use of non-business consumer credit report on the undersigned in order to further evaluate the credit worthiness of the undersigned as principal, proprietor and/or guarantor in connection with the extension of business credit as contemplated by this credit application. The undersigned hereby authorizes Besco to utilize a consumer credit report on the undersigned from time to time in connection with the extension or continuation of the business credit represented by this credit application. The undersigned as an individual hereby knowingly consents to the use of such credit report consistent with the Federal Fair Credit Reporting Act as contained in 15 U.S.C. @ 1681 et. seq.