| Full
Name of company: |
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| Address
of Business: |
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| Address: |
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| City: |
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| State/Province: |
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| ZIP/Postal
Code: |
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| Phone: |
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| Fax: |
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| Email
Address: |
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| Web
site: |
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| Check
one: |
Corporation
Proprietorship
Partnership |
| Number
of years in business(under current name): |
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| Number
of years at present location: |
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| If a partnership,
what are the full names and addresses of all your general partners? |
Partner # 1: |
| Name: |
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| Street: |
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| City: |
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| State: |
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| Telephone
Number: |
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Partner # 2: |
| Name: |
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| Street: |
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| City: |
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| State: |
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| Telephone
Number: |
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Partner #3: |
| Name: |
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| Street: |
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| City: |
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| State: |
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| Telephone
Number: |
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If an individual
proprietorship, what is the full name and residential address
of the sole proprietor? |
| Name: |
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| Street: |
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| City: |
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| State: |
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| Telephone
Number: |
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| Please list
four suppliers with which applicant has recent credit dealings
including the most recent supplier of printed materials. |
| Supplier
#1: |
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| Name: |
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| Street: |
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| City: |
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| State: |
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| Fax Number: |
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| Supplier
#2: |
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| Name: |
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| Street: |
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| City: |
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| State: |
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| Fax Number: |
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Supplier #3: |
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| Name: |
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| Street: |
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| City: |
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| State: |
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| Fax Number: |
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Supplier #4: |
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| Name: |
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| Street: |
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| City: |
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| State: |
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| Fax Number: |
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Tax
Exempt?
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No
Yes |
| Please
note, by law, we must apply tax, unless we receive the tax exempt
form. |
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The applicant understands and
agrees that:
- All of Presskits/Ardmore Graphic
Services, Inc. invoices are due and payable within 30 days
of our invoice date. Applicant hereby agrees to pay any interest
at the rate of 1.5 % per month, or an ANNUAL PERCENTAGE RATE
of 18%, on all accounts that remain unpaid after 30 days.
- If Presskits/Ardmore Graphic
Services, Inc. deems collection measures necessary after 30
days of our invoice date, applicant hereby agrees to pay any
and all costs of collection, including reasonable and customary
attorney fees.
- Are you tax exampt? Please fax
or mail completed tax exempt certificate.
- The above information is for
the purpose of obtaining credit and warranted to be true
and
hereby authorizes PRESSKITS/Ardmore
Graphic Services, Inc. to investigate the above statements
and references pertaining to our credit and financial responsibilities.
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| Name: |
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| Title: |
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| Date: |
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By submitting this form, you authorize
Presskits/Ardmore Graphic Services to perform a credit check
through the supplied information.
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