Fox Lumber Sales, Inc. Credit Application Salesperson:_____ |
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#25 Riverbend Court, P.O. Box 1000, Hamilton, Montana 59840 - Phone: (406)363-5140 Fax: (406)363-6774 |
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Corporate Applicants: |
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Full Legal Name: __________________________ |
Place of Incorporation: _____________________ |
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Officers: __________________________ |
Fed I.D.#: _______________________________ |
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President: ________________________________ |
Secretary: _______________________________ |
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Vice-President: ____________________________ |
Treasurer: _______________________________ |
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Other: ___________________________________ |
State Resale Cert. No: _____________________ (If left empty State sales tax will be added to all sales) |
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Mailing Address: |
Ship-to Address: |
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P.O. Box:___________ |
City: ______________ |
Street: _________________ |
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Street:______________ |
State: _____________ |
Street: _________________ |
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Street:______________ |
Zip: _______________ |
Other: _________________ |
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Individual Applicants (include all owners) |
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All Applicants: |
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Phone:____________ |
Fax: _________________ |
Web Site: _______________ |
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Bank:_____________ |
Address: ______________ |
Account: _______________ |
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_____________________ |
Contact: _______________ |
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Other Business Names: |
_____________________ |
_____________________ |
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Is Applicant? yes no |
Check if Applicable: |
Subsidiary of another business___ |
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Explain: ________________________________________________________________________________ |
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Purchasing Agent: __________________________ |
Payables Contact:_________________________ |
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Phone:____________ |
Fax: _________________ |
Phone: _________________ |
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Type of Business: ____________________________________________________ |
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Trade Credit References: |
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Name: ____________
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Address: ____________________ |
Phone: ________________ |
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_____________________________ |
Fax: __________________ |
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Name: _____________
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Address: ____________________ |
Phone: ________________ |
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_____________________________ |
Fax: __________________ |
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Name: _____________
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Address: ____________________ |
Phone: ________________ |
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_____________________________ |
Fax: __________________ |
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Important: Read and Sign |
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The undersigned certifies that the above information is true and accurate; gives Fox Dispatch and its affiliates (herein Fox) authority to conduct a credit inquiry; and binds applicant to abide by any credit and payment terms extended to applicant. Applicant further agrees to pay all collection charges, including attorney fees and costs; and grants to Fox a security interest in all goods it provides until paid in full. |
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Authorized Signature __________________________________________________________________ |
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Position: _______________________________________ |
Date: ____________________________ |
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Personal Guarantee: |
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In consideration for any credit extended, I hereby absolutely and unconditionally guarantee the full payment of all indebtedness to Fox whether by acceleration or otherwise, that applicant has or may incur, by reason of any goods purchased by applicant. |
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Signature: _______________________________________ |
Date: ____________________________ |
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Print Name, Title__________________________________ |
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