Corporate Office567 Cinnabar St.San Jose, CA 95110P (408) 282-2200F (408) 282-9711
Cash and Carry and Distribution Centers1800 Merced St., San Leandro, CA 94577385 Valley Drive, Brisbane, CA 940053575 Ramos Dr, W. Sacramento, CA 95691 567 Cinnabar St., San Jose, CA 95110
NEW ACCOUNT APPLICATION
BUSINESS BANKING INFORMATION
I (WE) hereby authorize PACIFIC GROSERVICE Dba: PITCOFOODS, hereinafter called COMPANY, to initiate debit entries to my (our)
Indicated below at the depository named below, hereinafter called DEPOSITORY, to credit the Same to such account.
This authorization is to remain in full force and effect until COMPANY has received written notification from me (or either of us) of its termination in such manner as to afford COMPANY and DEPOSITORY a reasonable opportunity to act on it.
NOTE: ALL WRITTEN DEBIT AUTHORIZATIONS MUST PROVIDE THAT THE RECEIVER MY REVOKE THE AUTHORIZATION ONLY BY NOTIFYING THE ORIGINATOR IN THE MANNER SPECIFIED IN THE AUTHORIZATION.
• ABC (Alcohol Beverage Control Resale License)• Cigarette and Retailers Tobacco License (non-required)• State Board of Equalization Sellers Permit• Drivers License• Voided Check
Note: if Nevada customer, must upload License from the Department of Taxation
ALL ARE REQUIRED TO COMPLETE APPLICATION
• There will be a $50.00 charge on your account for each returned check for insufficient funds • Merchandise purchased with tax exemption, will be solely for resale purposes. • In consideration of purchasing products from Pitco Foods, the undersigned agrees to pay any and all debts on demand/within terms to. • Futhermore, the undersigned hereby gives a continuing individual and personal guarantee and promise to pay creditor all sums due on demand. • In the event Pitco Foods must refer this agreement to an attorney or any such outside agency for collections, any and ALL fees accrued will be responsibility of applicant. The undersigned hereby consent(s) to (name of creditor)'s use of a non-business consumer credit report on the undersigned in order to further evaluate the creditworthiness of the undersigned as principal(s) proprietor(s) an/or guarantor(s) in connection with the extension of business credit as contemplated by this credit application. The undersigned hereby authorize(s) Pitco Foods to utilize a consumer credit report on the undersigned from time to time as needed in connection with the extension or continuation of the business credit represented by this credit application. The undersigned as (an) individual(s) hereby knowingly consent(s) to the use of such credit report consistent with the Federal Credit Reporting Act.
*By clicking "Submit" you consent and agree that your use of a key pad, mouse or other device to select an item, button, icon or similar act/action constitutes your signature, acceptance and agreement as if actually signed by you in writing. You understand and agree that your e-Signature executed in conjunction with the electronic submission of your application shall be legally binding and such transaction shall be considered authorized by you.
FOR OFFICE USE ONLY
VOD:_______________ Open Date:_______________ Rating:_______________ Re-eval:_______________
Credit:_______________ Terms:_______________ Matrix:_______________ Sales Rep:_______________ Sales Sup:_______________ Acct#:_______________