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Credit Application

For assistance call us at 908-351-8000

Company information  
Sales Person's Name State
Company Legal Name State Incorporated In
D/B/A Date Incorporated
Street Address Organization
City Corporation
State Partnership
Zip Code Proprietorship
Telephone It Operates as a  
Fax Chain
E-Mail Wholesaler
Name of Owner Retailer
Address Jobber
City Other
       
       
Bank Relationships  
Name of Bank Name of Bank
Account n° Account n°
Address Address
City City
State State
Zip Code Zip Code
Telephone Telephone
Fax Fax
       
 
Trade References  
Name Name
Telephone Telephone
Fax Fax
Address Address
City City
State State
Zip Code Zip Code
       
Name    
Telephone    
Fax    
Address    
City    
State    
Zip Code    
 
Credit Line Needed To Supply Account Per Month $
Amount Of first Order $
 
This Credit Application Must Be Signed And Acts As A Letter Authorizing Release of All Credit Information
Credit Agreement: In order to establish an open line of credit based upon this application, the applicant agrees to pay for all purchases in accordance with terms of sale. Applicant agrees to pay for any and all past due invoice(s) of the undersigned to Atalanta Corporation and shall bear interest at the rate of 1.5% per month or the highest rate permitted by law. Applicant also agrees to reimburse for any and all costs, such as but not limited to, collection agency fees, attorney fees, etc., incurred to collect any debt.
 
   

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