Credit Application

CREDIT APPLICATION

I hereby represent that I am authorized to submit this application on behalf of the customer named above, and that the information provided is for the purpose of obtaining credit and is warranted to be true. I/we hereby authorize AMERICAN ASSOCIATED COMPANIES, INC. to investigate the references listed pertaining to my/our credit and financial responsibility. It is agreed and understood that all necessary collection and legal expenses and interest (at 1.5% per month) may be charged to debtor in the event of default or failure to pay for goods sold and delivered. I further represent taht the customer applying for credit has the financial ability and willingness to pay all invoices within established terms. Payment(s) made beyond 30 days from date of invoice will be subject to finance charges of 1.5% of the unpaid balance.

Please provide the following company information:
Company Name
Address

City	St Zip
County	Country
Phone	Fax
E-Mail
D & B #	Tax ID#
Please provide the following shipping information:
Street Address

City	St Zip
County	Country
Type of business	Proprietorship Partnership Corporation Other
Owner's Name
Owner's SSN	Years in business
Please provide the following payables information:
Unit Manager
District Manager
Title
Phone
Address

City	St Zip
County	Country
Contact
Contact Title
Phone	Fax
E-mail
Please provide the following information for 3 trade references:
1. Organization
Address

City	St Zip
Country	Phone
2. Organization
Address

City	St Zip
Country	Phone
3. Organization
Address

City	St Zip
Country	Phone
Please provide the following bank reference information:
Contact
Bank
Phone
Account #
Please provide the following preparer information:
Name
Title
Tax Exempt #
Enter estimated monthly amount of credit needed
I hereby represent that I am authorized to submit this application on behalf of the customer named above, and that the information provided is for the purpose of obtaining credit and is warranted to be true. I/we hereby authorize AMERICAN ASSOCIATED COMPANIES, INC. to investigate the references listed pertaining to my/our credit and financial responsibility. It is agreed and understood that all necessary collection and legal expenses and interest (at 1.5% per month) may be charged to debtor in the event of default or failure to pay for goods sold and delivered. I further represent taht the customer applying for credit has the financial ability and willingness to pay all invoices within established terms. Payment(s) made beyond 30 days from date of invoice will be subject to finance charges of 1.5% of the unpaid balance.