Untitled Document

Sarasota Co. Phone
Sarasota Co, Fax

(941) 429-3600
(941) 429-3660

APPLICATION FOR CREDIT

NAME OF BUSINESS

ADDRESS

BILLING ADDRESS

CTY, STATE, ZIP

PHONE

CONTACT

TYPE OF FIRM

C- CORPORATION
S- CORPORATION
SP- SOLE PROPRIETOR
JV- CORPORATION
0- OTHER

SOCIAL SEC. # OR FED. ID #
DUN & BRADSTREET #
NAMES OF OFFICERS, PARTNERS, ETC. :

YEARS IN BUSINESS ________________________________________________________________________________

GEOGRAPHIC AREA OF WORK______________________________________________________________________

HAS FIRM EVER FAILED TO PAY A LEGAL OBLIGATION ?_____________________________________________

HAS FIRM EVER BEEN IN BANKRUPTCY ?____________________________________________________________

HAVE YOU APPLIED FOR AN ACCOUNT HERE BEFORE ? ________ IF YES, WHEN ? _______________________

CREDIT LIMIT REQUESTED:____________________ PURCHASE ORDER REQUIRED ? ______________________

	* TERMS: NET 30 DAYS
	* NOTICE TO OWNER WILL BE SENT IF NOT PAID WITHIN TERMS !

BANK REFERENCE:

	NAME
	ADDRESS
	PHONE #
	CONTACT ( e.g. loan officer) ____________________________

MAJOR BUSINESS / TRADE REFERENCES:

#1.	NAME
	ADDRESS
	PHONE #
	CONTACT

#2.	NAME
	ADDRESS
	PHONE #
	CONTACT

#3.	NAME
	ADDRESS
	PHONE #
	CONTACT

#4.	NAME
	ADDRESS
	PHONE #
	CONTACT

#5.	NAME
	ADDRESS
	PHONE #
	CONTACT

**By signing this application and in consideration of Davidson Insulation & Acoustics, Inc., granting credit, the undersigned personally guarantees the payment of any such sums or debts which may become due and payable to Davidson Insulation & Acoustics, Inc., and the undersigned further binds the coporation, partnership or business entity to the payment of any such sums or debts which may become due and payable to Davidson Insulation & Acoustics, Inc. which the undersigned represents. Upon approval the applicant understands that all purchases are due Net 30 days. In the event collection proceedings ar required to collect on a delinquent account, Davidson Insulation & Acoustics, Inc., shall be entitled to receive all costs of collection, including, but not limited to, reasonable attorney's fees, court costs and interest. I (we) hereby grant Davidson Insulation & Acoustics, Inc. permission to contact my (our) creditors for the purpose of establishing credit terms.

DATE:
SIGNATURE OF APPLICANT:
TITLE:

OFFICE USE ONLY

TITLE: _______________________________________________
SALESPERSON ________________________________________
DATE SUBMITTED: ___________________________________
APPROVED BY: _______________________________________
DATE: _______________________________________________
CREDIT LIMIT: _______________________________________