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    • BUSINESS INFORMATION  
    • DELIVERY/SHIPPING DETAILS  
    • MAIN CONTACT INFORMATION  
    • ACCOUNTS PAYABLE INFORMATION  
    • PAYMENT DETAILS  
    • TRADE REFERENCES (required if requesting terms)  
    • FILE UPLOADS  
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    • AGREEMENT  

    • I/We certify that the above information is true and correct and I/We agree to pay this account in accordance with your credit terms. In the event I/we should not be able to pay in accordance with your credit term, this is your authority to charge a finance charge of 1.5% per month (or a minimum charge of 75 cents for balances under $35.00) calculated on the last day of each month, on the balance as of the last day of the previous month (less payments and credits to said balance) until payment is made in full. This represents an annual percentage rate of 18%. I/We authorize you to verify this information and/or obtain additional information from a credit-reporting agency.
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