Reynolds Electric | Commercial Credit Application

Commercial Credit Application
You can also print out a PDF version to fill out and fax to our office.

Firm Name		Date
Billing Address	P.O. Box
City	State	Zip Code
Phone Number	Fax Number
	Organization Structure

If Corporation

President
Vice President
Secretary
Treasurer

If Individual or Partnership

Name
Social Security Number
Name
Social Security Number

Approximate monthly credit requirements:	$	Date business started or incorporated:
Have you ever applied for or been extended credit at Reynolds Electric Co. Inc.?		Yes No
If yes, under what name?
Has this Company or any predecessor company ever filed bankruptcy?		Yes No
If yes, please explain:
Are purchase orders required?	Yes No
Person to contact regarding Accounts Payable:
Classification:		If Other
Taxable Non-Taxable Sales Tax Permit Number:

Bank Reference

Name

Telephone Number

Address

City

State

Zip

Check Account #

Savings #

Loan #

Trade Reference

Name

Telephone Number

Fax Number

Address

City

State

Zip

Name

Telephone Number

Fax Number

Address

City

State

Zip

Name

Telephone Number

Fax Number

Address

City

State

Zip

Dun & Bradstreet Number:

You are hereby authoried to allow credit to me, or my company, until otherwise notified in writing. It is agreed that the applicant's signature attests financial responsibility, ability, and willingness to pay your invoice according to the following terms:

Invoices Due Upon Receipt
Finance Charge of 1 ½ % per month (18% per annum)
Or the maximum allowed by law added to ALL Balances of 30 Days or More

I/We authorize the bank and other creditors listed to release credit information to Reynolds Electric Co. Inc. for the purpose of establishing credit. The undersigned hereby states that the information contained herein to be true and correct.

Signature		Title
Address		City		State		Zip

By checking this box you agree to all terms set forth on this page. (Required)
(Application must be signed by Corporate Officer(s), Partner(s), or Individual owner.)

A Financial Statement would be most helpful in establishing a line of credit commensurate with your needs.

Personal Guarantee: In signing this application, I/We agree to pay all purchases within the terms set by Reynolds Electric Co. Inc. If it becomes necessary to effect collection, I/We will pay all reasonable collection fees, attorney fees, court costs, and interest at 1 ½ % service charge per month if the account becomes past due. If this business is a corporation, I/We agree to be personally responsible for any purchases made by the corporation, pursuant to this application. I/We do hereby waive notice of demand, protest or default and consent to any modification or renewal of the credit application hereby guaranteed. The above signed jointly and severally promise to pay all charges until such time as the guarantor shall withdraw his guarantee by written documented delivered by certified mail to Reynolds Electric Co. Inc.