| CREDIT APPLICATION |
| Credit is available, with prior application approval. Please print out the form below, fill it out & fax or mail the form back to Central Cash & Carry, San Jose |
| FAX# 408.975.7730 MAIL: Area Distributing, P. O. Box 8589, San Jose, CA 95155 |
Firm Name:_______________  Resale Permit#________________ |
| Billing Address: _________________________________ |
| City & State: _____________________ Zip Code: __________ |
| Business Phone: _______________ How long in business?_____ |
| Company is a ____ Sole Partnership ____Partnership ____Corporation |
| Have you ever filed bankruptcy? Yes___ No___ Year_________ |
| Name & Address (Principals) |
|
| Credit References: At least 3 (complete address with zip code) |
|
| Bank References (Complete address with zip code) |
| 1. ______________________________ Phone #___________ Checking #____________ Saving #________ Loan #_________ Person to Contact______________________________ |
| I hereby authorize Area Distributing, to whom this application is made, or any credit bureau employed by such person, to investigate any references herein listed or statements or other data obtained from me or from any person pertaining to my credit or financial responsibility. |
| Please Note: Accounts which have not been paid within 30 days of purchase date will be classified as "PAST DUE" and will be subject to service charges. Should suit be commenced and Attorney's fees be incurred to enforce payment of this account or any portion thereof, I agree to pay Attorney's fees in addition to the amount of the obligation. |
| The above statements are true to the best of my knowledge. |
| FIRM NAME:____________________ |
| By:_______________________ Title:________________ |
| Authorized Signature/Printed Signature |
| Other Authorized Signatures on Account:_____________________ |
| ____________________________________________________________ |