Fruge Seafood New Customer Application

Credit Application for Business Account
Name/Address

Credit Application for Business Account
Browse Files

Cancelof
Your Sales Rep's Email*
example@example.com
Company Name*
DBA
Federal Tax ID #*
Is Shipping same as billing
Billing Address*

Street Address

Street Address Line 2

CityState

Zip Code
Shipping Address*

Street Address

Street Address Line 2

CityState

Zip Code
Name of Credit App Requestor*

First NameLast Name
Phone Number*

Area CodePhone Number
E-mail of Credit App Requestor*
Company Info
Company Type
State
Years In Business
If Division/Subsidiary, Name of Parent Company:
Company Officers
Purchasing*
Name of Person Responsible
Email*
example@example.com
Phone Number*

Area CodePhone Number
Accounts Payable*
Name of Person Responsible
Email*
example@example.com
Phone Number*

Area CodePhone Number
President
Email
example@example.com
Phone Number

Area CodePhone Number
CFO
Email
example@example.com
Phone Number

Area CodePhone Number
Terms Requesting*
If Net 21 (CEO/CFO approval required)

Bank Information
Bank Name*
Bank Phone Number*

Area CodePhone Number
Bank Fax Number

Area CodePhone Number
Account #*
Bank Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
I, ,of do hereby, authorize you to release Fruge Seafood Company, any pertinent information needed in order to process a credit application for the purchase of fresh or frozen fish.
Signature of Authroized Bank Account Signer*

Clear
Signer Name*
Date

DayMonthYear
Date

Trade References

Add up to three references
Company Name
Contact Name
Terms
Opened Since
Account
Phone Number

Area CodePhone Number
Fax Number

Area CodePhone Number
E-mail
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Company Name
Contact Name
Terms
Opened Since
Account
Phone Number

Area CodePhone Number
Fax Number

Area CodePhone Number
E-mail
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Company Name
Contact Name
Terms
Opened Since
Account
Phone Number

Area CodePhone Number
Fax Number

Area CodePhone Number
E-mail
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Credit Policy Acceptance

Credit Policy
Credit Policy
1. Fruge Seafood Company requires full payment of all invoices according to terms on invoice. Acceptance of invoice admits acceptance of terms, products, and pricing stated on that invoice/delivery. Future terms are subject to change without notice.
2. Returns/credits must be noted on original invoice or reported to our office within 24 hours after receipt of goods, or the next business day in the event of weekend deliveries. Short paid invoices are out of terms and can affect extension of credit.
3. Late charges and interest may accrue at the highest rate allowed by law on any balance not paid when due.
4. Balances remaining over 60 days from the invoice date will be considered in default and customer will be liable for any and all costs of collection.
Customer also agrees to pay reasonable attorney’s fees and court and other costs if this account is placed in the hands of an attorney for
collection.
5. Because of the highly perishable nature of our products, we must require strict terms be kept. All accounts are either in terms or late according
to terms extended on each invoice.
6. Payments should be mailed to Fruge Seafood Company, P.O. Box 393, Branch, LA 70516.

I, the undersigned, agree to the CREDIT TERMS AND RETURN POLICIES STATED ABOVE, and grant permission to any of our references to provide Fruge Seafood Company with financial information concerning our company. I hereby certify that the information contained herein is complete and accurate. This information has been furnished with the understanding that it is to be used to determine the amount and conditions of the credit to be extended. Furthermore, I hereby authorize the financial institutions and trade references listed in this credit application to release necessary information to the company for which credit is being applied for in order to verify the information contained herein. I further certify that I have the authority to purchase goods on behalf of the above named entity and all charges will be paid on time and that said company and individual submit to the courts of both the state of Texas and Louisiana.
Signature*

Clear
Date

DayMonthYear
Date

Personal Guarantee
Personal Guarantee

I guarantee unconditionally and promise to pay to Fruge Seafood Company any and all amounts due and owed by Customer, including interest, late charges, and attorney’s fees, and to perform each obligation when due.
Signature

Clear
Date

DayMonthYear
Date
Signer Name*
Tile / Position*

Fruge Seafood Automatic Draft Form
Name of Business*
A/P First / Last Name*
Phone Number*

Area CodePhone Number
E-mail*
example@example.com
Billing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Checking Account Routing Number:*
Checking Account Number*
I, the undersigned, authorize Frugé Seafood Company to automatically draft the listed checking account for payment of invoices that are due.
Signature*

Clear
Date

DayMonthYear
Date
Signer Name*
Tile / Position*

Authorization to Charge Credit Card
Name on Card*
Phone Number for Card Number Collection*

Area CodePhone Number
E-mail*
example@example.com
Card #*
Exp. Date*
CC SEC CD*
I, the undersigned, authorized Frugé Seafood Company to bill the following credit card for payment of invoice. Any invoice for the above listed company that is signed by an authorized company representative is approved for payment on this card.

For security purposes, a person from Fruge Seafood accounting department will contact you to collect your full credit card details.
Signature*

Clear
Date

DayMonthYear
Date
Signer Name*

Thank You!

Press Submit Below
Should be Empty:

Credit Application for Business Account

Name/Address

Company Info

Company Officers

Bank Information

Trade References

Credit Policy Acceptance

Fruge Seafood Automatic Draft Form

Authorization to Charge Credit Card

Thank You!