| Account
Name______________________________________________________________________________________ Address_______________________________________ City___________________
State________ Zip_____________
Telephone_____________________________ Fax_________________________
Email__________________________
Resale Permit
No.___________________________________________________________________________________
Legal Owner
__________________________________________ SS
#________________________________________
Legal Owner
__________________________________________ SS
#________________________________________
Credit Terms
All information and representations in this credit application are correct
and complete. I will inform Moran Supply immediately by certified mail to : Credit Dept.,
Box 3088, Oakland, CA 94609,of any changes in this information or in my financial status
or my interest or position in any partnerships or corporations which purchase material
from Moran Supply. I understand that credit will not be granted in excess of regular terms
and I agree to pay a late charge of 2% per month (24% annually) on
purchases not paid by the 25th of the month after purchases are made.
I understand that my account may be put on credit hold if not
paid by the 25th of the month following purchases. I agree to pay a $15 service charge on
all returned checks. I understand that my account may be referred to a collection agency
or attorney if not paid within 60 days. I agree to pay all court costs and expenses of
collecting past due amounts,including but not limited to all actual attorney fees and
court costs incurred by Moran Supply.
I hereby give my consent to have Moran Supply obtain
information regarding my employment, checking and/or savings accounts and all other credit
matters. A photographic or carbon copy of this authorization bearing a photographic or
carbon copy of the signature of the undersigned may be deemed to be equivalent of the
original hereof and may be used as a duplicate original.
For valid consideration and in consideration for any extension
of credit to me, I personally guarantee payment for all future purchases made by me, made
by any partnership in which I am a partner at the time said purchases are made,or made by
any corporation in which I am an officer or in which I hold stock when said purchases are
made.
I/we certify that the above information is true and correct.
I/we fully understand your credit terms and agree to the proper payment in consideration
of payment extended.
Signature_____________________________________
Date___________________________
Title_________________________________________ |
Business Form: ___Individual
___Partnership ___Corp How Long in
Business____________
Other Affiliated
Companies____________________________________________________________________
Type of Business_________________________ Contractors
Lic #______________________ Est Net Worth________
Bank
Reference________________________________________________
Branch______________________________
Bank
Address__________________________________________________ City_______________
Phone_____________
Account
No.____________________________________________________ ___Loans
___Commer. Acct ___Savings
Trade References (list name, city and telephone number)
1._____________________________________________________________________________________________________
2._____________________________________________________________________________________________________
3._____________________________________________________________________________________________________
4._____________________________________________________________________________________________________
Have you ever failed in business__________ If yes,
explain on back of this form |
