CREDIT APPLICATION

Required Documents

Beechwood Credit Application
Prior to filling out the Credit Application please ensure you have the following information:

Credit Application

Beechwood Sales and Service
Thank you for your interest in working with us. Please complete the following form in full.

If you have any questions, please reach out to us at customerservice@beechwoodsales.com.
Account Contact Information
Account Name*
Account's Physical Address*

Street Address

Street Address Line 2

City

Zip Code
Account Phone Number*
Please enter a valid phone number for the business, not a personal cell phone number.
Email*
example@example.com
Do you already do business with us at another location?*

YesNo
Please list your other businesses below*

Licensing Information
Alcohol License Expiration Date*

MonthDayYear
Date
Licensee Name*
LLC, Corp, Inc. Etc.
License #*
Place of Issue*
I.e. City of Milwaukee
Credit Application
TO OBTAIN CREDIT FROM CREDITOR, {licenseeName} AGREES TO CREDITOR'S USUAL TERMS AND CONDITIONS AS PROMULAGATED AND AMENDED BY CREDITOR FROM TIME TO TIME, AND REPRESENTS AND STATES THE FOLLOWING, AND AUTHORIZES RELEASE OF ANY INFORMATION PERTAINING TO {licenseeName} FINANCIAL CONDITIONS FROM ANY THIRD PARTIES WHICH MAY VERIFY SAME:

"CREDITOR" is BEECHWOOD DISTRIBUTORS, INC.

"CUSTOMER" is: {accountName}		Telephone #: {accountPhone}
Address: {sourceaddress}		Email: {email}
Licensee Name: {licenseeName}		Exp Date: {AppAlcoholLicense15}
License #: {license}		Place of Issue: {placeOf}

Please verify that the information above is correct.

Tax Exempt Number:
CUSTOMER is a (check where appropriate)*

SOLE OWNERPARTNERSHIPCORPORATIONLLC
Owner Name*

First NameLast Name
Owner Phone*
Social Security Number*
Owner Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Partner's Name*

First NameLast Name
Social Security Number*
Partner's Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Corporate Name*
Business Phone*
State of Incorporation*
Corporate Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
President*

First NameLast Name
President's SSN*
President's Home Phone Number*
Please enter a valid phone number.
President Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Vice President*

First NameLast Name
Vice President's SSN*
Vice President's Home Phone Number*
Please enter a valid phone number.
Vice President Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Other Partners - Attach List

Cancelof
LLC (Limited Liability Co. Name)*
Business Phone*
State of Charter*
Business Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Member*

First NameLast Name
Member SSN*
Member Home Phone Number*
Please enter a valid phone number.
Member Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Attach a list of the name, title and home address of all other Members and Managers of Customer

Cancelof
Please take a photo OR upload an image of your IRS Form W-9, titled "Request for Taxpayer Identification Number and Certification".*

Take a photoUpload an image
Take Photo*
Upload an Image*

Cancelof
Employer Identification Number*
Employer Identification Number should be 9 digits. This is the same as the FID number.
Business Bank Account & Reference*
Address of Bank*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Contact Person*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Total Employees of Your Business*
Year Business Started*
Please list three business/trade references:
4. {licenseeName} AGREES TO PAY SERVICE CHARGES OF 2% PER MONTH OR THE HIGHEST RATE ALLOWED BY LAW (WHICHEVER IS LESSER) FROM THE DUE DATE OF EACH INVOICE TO DATE OF PAYMENT. IN THE EVENT OF {licenseeName}'S ACCOUNT IS PLACED FOR COLLECTION, {licenseeName} AGREES TO COLLECTION AND/OR ATTORNEY FEES OF 25% OF THE AMOUNT OWED.

5. {licenseeName} HEREBY CONSENTS TO AND SUBMITS TO THE PERSONAL AND SUBJECT MATTER JURISDICTION AND VENUE OF ANY STATE COURT SITUATED IN WAUKESHA COUNTY, WISCONSIN AND OF ANY FEDERAL COURT SITUATED IN MILWAUKEE COUNTY, WISCONSIN, AND WAIVES ANY OBJECTION BASED ON FORUM NON CONVENIENS, WITH REGARD TO ANY ACTIONS, CLAIMS, DISPUTES, OR PROCEEDINGS RELATING TO THIS CREDIT APPLICATION, ANY TRANSACTIONS ARISING THEREFROM OR ANY OTHER DEALINGS BETWEEN {licenseeName} AND CREDITOR, OR ENFORCEMENT AND/OR INTERPRETATION OF ANY OF THE FOREGOING. Nothing herein will affect Creditor's rights to serve process in any manner permitted by law, or limit Creditor's right to bring proceedings against {alcoholLicensee} in the competent courts of any other jurisdiction or jurisdictions.

7. Personal Guaranty IN CONSIDERATION OF CREDITOR EXTENDING CREDIT TO {alcoholLicensee}, THE UNDERSIGNED PERSONALLY AND INDIVIDUALLY GUARANTEE UNCONDITIONALLY FULL AND PROMPT PAYMENT OF PAST, PRESENT AND FUTURE OBLIGATIONS AND TERMS DUE CREDITOR FROM {licenseeName}, AND/OR ANY SUCCESSOR IN INTEREST GUARANTY, NOTICE OF RENDERING SERVICES AND/OR SALE OF GOODS PROVIDED {licenseeName} BY CREDITOR AND NOTICE OF DEFAULT OR CHANGE OR EXTENSION OF CREDIT TERMS. THE TERM "OBLIGATIONS" AS USED HEREIN ALSO INCLUDES THE AMOUNT OF PAYMENTS MADE TO CREDITOR OR ANOTHER BY OR ON BEHALF OF {licenseeName} WHICH ARE RECOVERED FROM CREDITOR BY A TRUSTEE, RECEIVER, CREDITOR OR OTHER PARTY PURSUANT TO FEDERAL OR STATE LAW. THE UNDERSIGNED CONSENT TO ANY EXTENSION OF TIME FOR PAYMENT AND ASSERT THAT THIS IS A CONTINUING GUARANTY OF PAYMENT TO CREDITOR UNTIL REVOKED IN WRITING; PROVIDED, HOWEVER, THAT THIS GUARANTY SHALL CONTINUE IN FULL FORCE AND EFFECT AS TO OBLIGATION CONTRACTED FOR OR INCURRED BEFORE SUCH REVOCATION. EACH OF THE UNDERSIGNED WHO IS MARRIED REPRESENTS THAT THE OBLIGATIONS HEREUNDER ARE INCURRED IN THE INTEREST OF HIS OR HER MARRIAGE OR FAMILY.

ALL OWNERS, PARTNERS, OFFICERS, MEMBERS OR MANAGERS OF CUSTOMER SHOULD SIGN AND BE BOUND PERSONALLY.

Billing Information
Billing Contact Name

First NameLast Name
Billing Contact Phone Number
Billing Contact Email
example@example.com
Do you have a different address for billing?*

YesNo
Billing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Terms & Conditions*
Terms & Conditions
I hereby certify that the information contained herein is complete and accurate, and the person executing this agreement has authority to bind the retailer and is authorized by the retailer to enter into the credit application terms and conditions. This information has been furnished with the understanding that it is to be used to determine the amount and conditions of the credit terms to be extended. Furthermore, I hereby authorize the financial institutions 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. The undersigned hereby acknowledges and agrees to all the terms and conditions of this Credit Application and acknowledges that completion of this Credit Application does not guarantee credit terms. All credit terms will be in compliance with state alcohol laws and regulations. The undersigned understands that L. Knife & Son must be notified in writing by certified mail of any change in ownership, the name or business structure under which credit is established. The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, national original, sex, marital status, age, (provided the applicant has the capacity to enter into a binding contract), because all or part of the applicants income derives from any public assistance program, or because the applicant has in good faith exercised any right under the consumer credit protection act to the extent is would apply. Valid retailer alcohol license or tax exempt form must accompany this application to complete the processing.
You will automatically be enrolled in Retailer Portal, our online customer service portal. By clicking the submit button, you acknowledge that you are authorized from the Licensee to make electronic orders and payments for this account. You will receive an email at {primaryContacts9} with instructions to access Retailer Portal.
Signature*

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Required Documents

Credit Application

Account Contact Information

Licensing Information

Credit Application

Billing Information