Credit Application

Company Information
Exact Corporate Name
State of Incorporation		Date of Incorporation
Corporate ID#		Federal ID#
Street Address		Billing Address
City		City
State ZIP		State ZIP
Telephone		Telephone
Fax		Fax
Bank References
Bank Name		Account #		Account Rep
Address
Trade References
Name		Name		Name
Address		Address		Address
Telephone		Telephone		Telephone
Fax		Fax		Fax
Account Type		Account Type		Account Type
No.		No.		No.
It is requested that credit privileges be extended to the company making application herein. It is agreed that all charges will be paid within the designated terms of thirty (30) days from the date of the invoice. Failure to do so will result in the withdrawal of credit privileges and any special provisions granted. It is understood that payments not received within thirty (30) days from the invoice date will be assessed interest at the rate of one and one-half percent (1.5%) per month or fraction thereof. It is further understood that the company making application will be responsible for and pay all costs of collecting past-due amounts, including collection and attorney fees, whether or not suit is filed. Venue for all legal actions shall be in Santa Clara County, California.