Credit Application

The Customer hereby applies to Wholesale Janitorial Supply Inc. ("WJS") for credit terms as indicated below and certifies that the information below is true and complete and is furnished with the intent that it be relied upon by Wholesale Janitorial Supply Inc. in granting credit.

The Customer agrees to notify WJS immediately of any change in Company ownership. If granted credit by WJS, the Customer agrees to pay all invoices according to the terms set by Wholesale Janitorial Supply Inc.

Company Information

Full legal name of business____________________________________________

Address____________________________________________________________

City __________________ State_________________ Zip ____________

Business Phone____________________ Business Fax____________________

Contact person (First and Last name)______________________________

Contact person's e-mail address___________________________________

Contact person's direct phone number____________________________

Business Tax Id# or EIN______________________________________

Year Established___________________

Legal Form of Business_____Propriatorship_____Partnership_____Corporation

Describe line of Business_______________________________________

____________________________________________________________

Average Anticipated Monthly Purchases__________________________

 

 

 

 

Trade References (Suppliers Not Service Companies)

1. Company Name_________________________Account #_____________

Contact_____________________ Contact Phone #____________________

Address______________________________________________________

City__________________ State_____________ Zip___________________

2. Company Name_________________________Account #_____________

Contact_____________________ Contact Phone #____________________

Address______________________________________________________

City__________________ State_____________ Zip___________________

Credit/Bank Information

1. Bank Name______________________ Account #___________________

Address___________________________________________

City__________________State__________________ Zip_______________

Contact________________________ Phone #________________________

My signature below authorizes my bank to release information about my account for the purposes of establishing credit with Wholesale Janitorial Supply Inc. I authorize the release of information regarding my accounts history, average daily balances, and standing.

Signature___________________________
            (of authorized signer on the account)

Print Name:__________________________

 

Credit Card information*(Not applicable if applicant is a government, education, or publically run entity)

Accounts will not be approved without a valid credit card.

1. Name on Card ________________________ Type of card (circle one) visa mastercard discover amex

Card #___________________________________________

exp. date__________________ cvs (last 3 digits on back of card)__________________

My signature below authorizes the use of the above card to be used for invoices over 60 days past due.

Signature___________________________

 

 

 

Terms

The Customer authorizes Wholesale Janitorial Supply Inc. to obtain such information regarding the Customer in connection with the credit hereby applied for and the Customer consents to the disclosure at any time of any information concerning the Customer from any credit reporting agency or credit grantor with whom the Customer has financial relations. Wholesale Janitorial Supply Inc. may retain this application for its records. The Customer makes the foregoing confidential application for credit, with the understanding that Wholesale Janitorial Supply Inc. will be relying upon it for the purpose of the Customer obtaining merchandise on credit from Wholesale Janitorial Supply Inc. This is an Application and Agreement for credit and shall apply to any and all credit extended by Wholesale Janitorial Supply Inc. The Customer understands and agrees to the following terms and conditions of sale.

  1. 1. Terms of sale are net 30 days. Agents or representatives of Wholesale Janitorial Supply Inc. are not authorized to change or adjust the credit terms without the written authorization of the President. 2. All claims against invoices must be made within 30 days after receipt of goods. 3. All invoices are to be paid promptly according to the credit terms established. Failure to comply with the credit terms established may result in cancellation of credit privileges without notice. 4. A Service Charge of $20.00 will be applied to the account for any Dishonoured (Returned ) Checks. 5. Accounts not paid by the due date are subject to an interest charge from the date of maturity at the rate of 1.5% per month (18% per annum). 6. Goods may not be returned without prior authorization of Wholesale Janitorial Supply Inc. 7. Goods / merchandise authorized for return will be subject to a minimum 10% restocking charge. 8. Applicant agrees to bear all costs incurred in collecting any unpaid account balances including but not limited to collection suit fees, legal fees and court costs.
  2. 9. Upon obtaining information that the Customer's credit worthiness has changed adversely or does not satisfy the current credit standards, Wholesale Janitorial Supply Inc. may adjust the credit limits accordingly.


Signature:_______________________ Title:___________________________
                   Authorized Officer

Date:___________________________

 

 

 

Print and Fax to (480) 451-8488