Credit App | AG004

Credit Terms Application
Business Contact Info
Company Name*
Company Type*

Sole ProprietorshipPartnershipLLCCorporationNon-Profit Corporation
Sales Tax Exempt
A Yes is rare. Additional Documentation would be Required.
Tax Exempt Documentation

Upload Files
Please upload documentation from the Department of Revenue Cancelof
dba Company Name
Phone Number*
Format: (000) 000-0000.
Web Address
Company Shipping Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Business and Credit Info
Accounts Payable Contact*

First NameLast Name
Accounts Payable Phone*
Format: (000) 000-0000.
Accounts Payable E-mail*
Company Bill To Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
PO Required?

YesNo
Billing is electronic should we send to:*

Buyer of record onlyA/P e-mail onlyBoth Buyer and A/P e-mails
Upload Credit References

Upload Files
optional Cancelof

Agreement

(By checking these boxes you are agreeing to our terms - should you have any questions please contact us)
Agreement and Terms*

I understand all charged invoices are payable 30 days after invoice date and that a service fee of 1.5% per month will be added to all past due accounts. In the event payment is not made and account is referred to a collection agency, or if legal action is required I will pay collection and/or attorney's fees resulting from such action.
Agreement and Terms*

I understand that all disputes must be addressed within 30 days of receipt of product. Alphagraphics cannot research disputes on product older than 30 days.
Agreement and Terms*

By submitting this credit application, you authorize us to make inquires into the banking and trade references that you provided.
Enter the word as it's shown*
Signature*
Name
Title
Date

MonthDayYear
Date
Should be Empty:

Credit Terms Application