• CUSTOMER CREDIT APPLICATION

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  • Names of Principal Stockholder & % of Interest:

  • Names of Corporate Officers:

  • Partnership or Proprietorship Name (If Applicable):

  • Billing Information

  • Shipping Information

  • IF YOU ARE A TAX EXEMPT ORGANIZATION ATTACH A COPY OF EXEMPTION CERTIFICATE:

  • IF YOU ARE A RESALE ORGANIZATION, LIST ALL TAX NUMBERS:

  • Welch terms are net 30 with credit approval unless stated otherwise approved. Past due accounts may be subject to a finance charge. If litigation is necessary to resolve an outstanding debt, the prevailing party shall be further reimbursed for any and all reasonable attorney fees and court costs. The understand applicant, to establish credit, furnishes the above information and warrants said information to be true, accurate, and complete. The undersigned is legally authorized to obligate the above named applicant to all the terms and conditions of sale of Welch Equipment Company. All information in this application shall be kept confidential.

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