Connecticut Floor Store – Credit Application

 

Company Name ________________________________________________________________________


Legal Name ___________________________________________________________________________

 

Address ______________________________________________________________________________

 

Business Started On ___/___/___

 

City __________________ State ____ Zip _______ D&B # ____________________________________

 

Phone ____________ Cell ____________ Fax ____________

 

Type Of Business  Corporation  Sole Proprietorship  Partnership Other 

 

Resale # _________________________

---------------------------------------------------------------------------------------------------------------------------------

 

Principal Name ____________________________Principal Name #2 ___________________________

 

Home Address ___________________________ Home Address #2 _____________________________

 

City _______________   State ___   Zip _____________

 

Phone ____________   Phone #2 ________________

 

SSN _________________ SSN _________________

 

Bank Name ___________________________ Phone _____________ Contact _____________________

 

 

Reference Name

Phone #

Contact

A/C #

 

 

 

 

1)

 

 

 

2)

 

 

 

3)

 

 

 

4)

 

 

 

 

     In giving credit to the companies and persons listed in the above application, the undersigned guarantees payment of all material purchased by said companies or persons. The undersigned waives notice of acceptance of this guarantee and notice of any default demand of every kin, nature and description. This shall be a continuing guarantee and shall not be affected by any payment, modification, or addition. There will be a late charge of 1.5% per month for past due balances (18% per year.) The undersigned will be responsible for invoices and agrees to our return policy, which is a 15% finance charge on full, unopened packages or cartons of merchandise within 10 days of original invoice. The undersigned authorizes all bank and trade references to release any and all information to any and all the above companies for the purpose of extending credit to the above named companies or persons.

 

 

 

 

 

 

Title

Date

Title

Date

x

x

x

x

Phone:  (203) 406-0062

Fax:  (203) 406-0299

www.ctfloor.com

support@ctfloor.com