Credit Account Application

Credit Account Application

invoice@edensaw.c o m | (360)385-7878 | www.edensaw.com
Customer Name*

First NameLast Name
Business Name
Date*

MonthDayYear
Phone Number*
Ship-To Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Customer Email*
example@example.com
Purchaser*

First NameLast Name

BILLING INFO
BILL-TO ADDRESS

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number
Please enter a valid phone number.
A/P Contact

First NameLast Name
A/P Email
example@example.com
Business Entity Type

LLCCorporationSole Proprietor
Tax ID
Date Business Opened
Contractor's License
UBI #
WA State Reseller Permit#
Bond #
Bonding Company
Bond Company Address
The State of Washington requires that we have a Reseller Permit on file for all tax exempt customers. If you want your account to be tax exempt please upload a copy of your Reseller Permit along with this application.
Reseller Permit Upload

Cancelof

BANK REFERENCES:
Bank
Branch
Account #
Contact Person
Contact Phone Number
Please enter a valid phone number.
TRADE/CREDIT REFERENCES:
1. Firm
Account #
Phone Number
Please enter a valid phone number.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
2. Firm
Account #
Phone Number
Please enter a valid phone number.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
3. Firm
Account #
Phone Number
Please enter a valid phone number.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

AUTHORIZATION TO BILL CREDIT CARD

I authorize Edensaw Woods, Ltd. to bill my credit card for purchases that I or my company have made with Edensaw Woods, Ltd. A 3% processing charge will be added to credit card purchases.
Payment Method

Please bill my credit card per invoiceI prefer to pay COD with cash or check
Business Name
Name on Credit Card

First NameLast Name
Position
Email
example@example.com
Address credit card company uses to send statements to you:
Name
Billing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

AUTHORIZED PURCHASERS:
1. Name
2. Name
3. Name
4. Name
5. Name
6. Name
Purchase Order Required?

YesNo
AGREEMENT TO TERMS:

I hereby certify that the information provided herein is complete and accurate. This information has been furnished with the understanding that it is confidential and is solely to be used to determine the amount and conditions of the credit to be extended.

This signature hereby authorizes the financial institution to furnish Edensaw Woods, LTD with relevant credit and banking information to verify any information provided by applicant. This Credit Account Application shall continue in full force and effect until such time as one party shall receive from the other party (by personal delivery or by certified or registered mail) written notice of revocation and/or change of status.

All credit extended shall be in accordance with the terms of individual invoices. Cash discounts, when available, are extended only to accounts which are current. All payments received will apply to oldest outstanding invoices first unless otherwise stated. A Service Charge amounting to 1-1/2% per month (18% per annum) will be charged on the last day of each month, for all delinquent amounts due. This agreement shall only be amended in writing with the signatures of both parties. Applicant/Customer agrees to pay attorney fees and costs for any collection efforts. Jurisdiction and venue for all legal proceedings between the parties shall be in Washington Courts, Jefferson County. This agreement shall be governed by the laws of the State of Washington.

Signature and Title of Applicant:
(If a corporation, an authorized Corporate Officer must sign, if a Partnership, all Partners must sign.)
Signer #1
Title
SS#
Date
Signer #2
Title
SS#
Signature

Clear
Date
Signer #3
Title
SS#
Signature

Clear
Date
Should be Empty:

BILLING INFO

AUTHORIZATION TO BILL CREDIT CARD