Credit Application Billing / Trade Name: Corporate Name: Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Accounts Payable RepresentativeRepresentative Name PhoneFaxEmail(Required) Business InformationType Sole Proprietor Partnership Private Corporation Public Corporation Not For Profit Corp Time in Business # of EmployeesResale # Bank / Credit ReferencesList at least oneNameContact NamePhoneAccount # Add RemoveLocal Trade ReferencesList at least oneNameContact NamePhoneAccount # Add RemoveSignature(Required)I authorize the firms listed above to release information pertaining to my firm. Reset signature Signature locked. Reset to sign again Consent to Garment Setup Policy(Required) I agree to the garment setup policyPlease note all garment set up’s will be charged Minimum weekly as indicated on your invoice weather you send garments back or not. There will also be a set up charge for all garments of $25.00. Consent to Personal Guarantee(Required) I agree to the personal guaranteePersonal Guarantee: The undersigned hereby absolutely and unconditionally guarantee prompt payment when debt incurred by the above company. This guarantee shall also bind the heirs, personal representative successors and assigns of the undersigned, and shall insure to the creditor, its successors and assets. We certify that all information of the form is correct. We fully understand your credit terms of net 30 days.Credit Amount RequestedName Date MM slash DD slash YYYY Signature(Required) Reset signature Signature locked. Reset to sign again
