Tewksbury Technical Coatings - Credit Application

Credit Application

The credit application for Tewksbury Technical Coatings customers. Please fill this form out completely.

Credit Application

Legal Business Name *

Billing Address *

Shipping Address *

Telephone *

Fax

Fed Tax ID # *

State Seller's Permit #

Type of Business

Years in Business

Years in business at this address

Amount of credit requested

Authorized Purchasers

Purchase Order required?

Yes No

Partnership or Proprietorship:

Name	Home Address	SSN

Corporation:

Name & Title	Address	Telephone

Trade References:

Company Name	Address	Account	Contact	Fax

Bank	Account	Contact	Telephone

Have you ever filed for bankruptcy?

Yes No

Do you have any open judgments or tax liens?

Yes No

Agreement

This application and the information contained herein is a request for the extension of credit. The applicant authorizes Tewksbury Technical Coatings, Inc. to obtain a written or oral credit report from any credit reporting agency, and that agency to give any and all necessary information to Tewksbury Technical Coatings, Inc., which will assist Tewksbury Technical Coatings, Inc. in the credit investigation. If a credit report is needed for legitimate credit purposes, the applicant hereby gives consent to obtain a current credit report. The applicant further authorizes Tewksbury Technical Coatings, Inc. to reinvestigate the applicant’s credit status periodically to maintain current credit information on file. Tewksbury Technical Coatings, Inc. reserves the right to limit or terminate the credit arrangement with applicant.

The applicant agrees to pay all invoices within specified terms. In the event payment is not made and the account is sent to collection, the applicant agrees to pay all costs of collecting or securing or attempting to collect or secure the debt, including reasonable attorney’s fees, whether the debt is secured by, or any attorney consulted with for reference to suit or otherwise. Also, the applicant understands interest on any unpaid balance will be charged at the highest rate authorized by law. It is understood and agreed that in the event of suit or action, it shall take place in Solano County, California in appropriate jurisdiction for Tewksbury Technical Coatings, Inc. The applicant verifies with signature below that applicant waives their right to litigate outside Solano County.

I REPRESENT THAT THE ABOVE INFORMATION IS TRUE AND IS GIVEN TO TEWKSBURY TECHNICAL COATINGS (TTC) TO EXTEND CREDIT TO THE APPLICANT. MY COMPANY AND I AUTHORIZE TO MAKE SUCH CREDIT INVESTIGATION AS SEES FIT, INCLUDING CONTACTING THE ABOVE TRADE REFERENCES AND BANKS AND OBTAINING CREDIT REPORTS. MY COMPANY AND I AUTHORIZE ALL TRADE REFERENCES, BANKS, AND CREDIT REPORTING AGENCISE TO DISCLOSE TO ANY AND ALL INFORMATION CONCERNING THE FINANCIAL AND CREDIT HISTORY OF MY COMPANY AND MYSELF.

I HAVE READ THE TERMS AND CONDITIONS STATED BELOW AND AGREE TO ALL OF THESE TERMS AND CONDITIONS.

Fields marked with an asterisk are required.