Credit Application Form

Application for Credit

Note: Fill out all applicable sections completely.
Date

MonthDayYear
Date
For Individuals and Sole Proprietorships
Applicant Name

First NameLast Name
Business Name
Business Type
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How Long at Address
How Long in Business
Current/Previous Employer
Phone Number
Please enter a valid phone number.
Email
example@example.com
For Partnerships
Business Name
Tax ID Number
Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Name of Partner (1)

First NameLast Name
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
Name of Partner (2)

First NameLast Name
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
For Corporations
Business Name
Tax ID Number
Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Officer Name
Title
Click if Non-Profit (Note: Must attach a non-profit certificate)Click if Tax Exempt (Note: Must attach a tax exempt certificate)
Certificates

Cancelof

Billing
Carr Hardware offers all customers billing via email. Please give all email addresses of all individuals that should receive invoices and statements.
Emails
Carr also offers free online access to invoices, statements, and daily activity with a product called "iNet". Please contact the Credit Department at 413-443-5611 for more details.
List specific account restrictions (such as P.O. requirements or ID's needed):
Charge Authorization

In the event that I/we are approved for a Carr Hardware charge account, I authorize the following individual(s) to charge to our account:
Name (1)

First NameLast Name
Name (2)

First NameLast Name
Name (3)

First NameLast Name
Name (4)

First NameLast Name
Name (5)

First NameLast Name
Name (6)

First NameLast Name
Only these individuals are authorized to make any changes to the account:
Name (1)

First NameLast Name
Title
Name (2)

First NameLast Name
Title
Note: Any changes should be emailed to credit@carrhardware.com by the authorized individual(s).
References
Business References
Company Name (1)
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Account Number
Company Name (2)
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Account Number
Company Name (3)
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Account Number
Bank Reference
Bank Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Account Number

Carr Hardware Credit Report Authorization Form

Note: This form must be filled out and signed by the individual, or 2 partners, or corporate officer.
Name

First NameLast Name
Address (No PO Boxes)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Social Security Number:
Date of Birth:

MonthDayYear
Date
Phone Number
Please enter a valid phone number.
I authorize Carr Hardware to contact credit reporting agencies (Experian, Dun and Bradstreet, etc.) and others with regard to the status of any past or outstanding debt or other such credit information that such agencies normally hold available for credit worthiness evaluation at present or at any time in the future for the purpose of obtaining a store charge account.

I understand that the report is for Carr Hardware use only and I will not be able to obtain a copy for my own records. However, I understand that representative of Carr Hardware may discuss this report with me in detail and I may call the reporting agencies individually and obtain my own copy of a similar report.
Authorized Signature

Clear
Date

MonthDayYear
Date
Agreement
In consideration of your buying merchandise from us on Carr Hardware's charge plan, you agree to the following:
1. You have the privilege of a 30 day charge account and you agree to pay the full balance owed within 25 days from the date of each billing statement.
2. If you do not pay the full balance owed within 25 days from the date of each billing statement:
  1. A finance charge at a periodic rate of 1 1/2% per month will apply to the remaining monthly balance (equivalent to an Annual Percentage Rate of 18%) with a minimum finance charge of 50 cents per month.
  2. You agree that if you do not pay the amount due and Carr Hardware is required to institute collection proceedings, you will pay for all cost of collections including reasonable attorney's fees.
3. If the account balance goes over 60 days past due, Carr Hardware reserves the right to put the account on a temporary credit suspension until payment is made in full.
4. If the account goes past 60 days more than once, Carr Hardware reserves the right to review the account and remove the discount. Please communicate with us if you are having difficulties paying on your account.
5. You are entitled to a copy of this agreement.
6. You may at any time pay off the full open balance of your account.
7. If there is no activity on your account for a period of 12 months, Carr Hardware reserves the right to close the account.
8. Carr Hardware has no right to unlawfully enter our premises or commit any breach of the peace to repossess goods purchased under this agreement.
Authorized Signature

Clear
Date

MonthDayYear
Date
Name

First NameLast Name
Title
GUARANTOR'S STATEMENT

I hearby guarantee full payment of this account, according to the terms outlined above.
Guarantor's Signature

Clear
Date

MonthDayYear
Date
Name

First NameLast Name
Title
Should be Empty:

Application for Credit

For Individuals and Sole Proprietorships

For Partnerships

For Corporations

Billing

References

Carr Hardware Credit Report Authorization Form

Agreement