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Please copy and paste or print out page.
CREDIT APPLICATION
We
are hereby requesting a credit account with Arizona Post
Tension.
We are presently a: ___Corporation
___Partnership ___Proprietorship
Name of
Firm__________________________________________________
Address______________________________________________________
City____________________
State_____ Zip _______________
Phone#______________________ Ext______
Fax#______________
Sales Tax# ________________________________
Type
of Business___________________________
Established Date____________ # of
Employees________
Owners and/or officers:
Name_____________________________________
Title_______________
Address__________________________________
Phone______________
Name_____________________________________
Title_______________
Address__________________________________
Phone______________
Name_____________________________________
Title_______________
Address__________________________________
Phone______________
Credit References:
Name_____________________________________
Title_______________
Address__________________________________
Phone______________
Name_____________________________________
Title_______________
Address__________________________________
Phone______________
Name_____________________________________
Title_______________
Address__________________________________
Phone______________
Please fill the following
completely.
Terms of Payment: Unless otherwise
agreed in writing, applicant agrees to pay the amount
due and owing thirty days from the date invoiced in the
event payment is not made in accordance with the
foregoing. We agree to a service charge of 1-1/2%
monthly (annual 18% interest rate) on past due accounts.
Dated this ________ Day of _______ 20_______
Signed_____________________________________ Title
____________________________
***GUARANTEE***
The undersigned, in consideration of the applicant
herein receiving credit from Arizona Post Tension, do
hereby unconditionally, jointly, and severally guarantee
payment of any and all bills or obligations incurred for
services performed by Arizona Post Tension, for
applicant and agree to promptly pay any and all such
bills that are not paid by applicant when due.
Dated this________ Day of_______ 20_______
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Name |
______________________________ |
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Name |
______________________________ |
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Address |
______________________________ |
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Address |
______________________________ |
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Signature |
______________________________ |
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Signature |
______________________________ |
Accounts Payable Contact:
__________________________________________
Phone:
______________________________
Email:
______________________________
When form printed and filled it out, fax
to
Arizona Post Tension, Accounts Dept.
520-623-3120
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