V3 Credit Application

Credit Application

5282 East Paris Ave SE Suite 300 Grand Rapids, MI 49512 | 616-656-2039
Complete Legal Business Name*
Federal Tax ID Number*
Address*

Current Address

Street Address Line 2

CityState

Zip Code
Telephone*
Fax*
Email Address*
example@example.com
Website Address*
Date of Incorporation*

MonthDayYear
Date
Date Business Started*

MonthDayYear
Date
Business Type*
President or Principal Officer*
Vice President or Principal Officer*
Controller or Principal Officer*
Trade References
Do You Have a Standard Bank/Trade Sheet Prefilled?*
Upload Standard Bank/Trade Sheet Here

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Trade Reference Contact Information*
Bank Reference

Your authorization and account numbers are necessary for your bank to release any information to V3 Distribution
Bank Name*
Contact Name*
Email*
example@example.com
Account Number(s)*
Address*

Address

Street Address Line 2

CityState

Zip Code
Payment Terms Requested*
Please note options over Net 30 require additional approvals
Amount of Credit Requested*
Please Include a copy of your Resale Certificate or Tax Exemption Certificate.

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V3 Distribution, in reliance upon the statements and representations contained in this Credit Application and Agreement, may extend credit to the applicant company named in this agreement for the purchase of products and services. Credit may be extended on open account, by acceptance of company check, prepayment, C.O.D. terms, or by invoicing with terms requiring form of payment other than cash. V3 Distribution reserves the right in the absence of open-account credit terms to require prepayment, deposit, or any form of surety as needed. If credit is extended, the applicant company agrees as follows: (1) to pay all invoices when due, according to the terms of sale listed on each invoice or as stated in letter of approval for open-account term sale, (2) that all past due invoices are subject to a late charge equal to 18% per year 1 1/2% per month), (3) to pay all collection fees, reasonable attorney fees, court costs, and other expenses incurred by the Seller to effect recovery of sums due from the applicant company in the event of nonpayment, (4) that all disputes shall be governed by the laws of and filed only on the State of Michigan, (5) that all information provided on this application is true and that the undersigned is an authorized agent on behalf of applicant company.
Authorized Signature*

Clear
Name*

First NameLast Name
Title*
Date*

MonthDayYear
Date
The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicant on the basis of race, color, religion, national origin, sex, marital status, age (provided the applicant has the capacity to enter into a binding contract); because all or part of the applicant's income derives from any public assistance program; or because the applicant has in good faith exercised and right under the Consumer Protection Act. The Federal agency that administers compliance with this law concerning this creditor is the Federal Trade Commission, Equal Credit Opportunity, Washington, D.C. 20580.
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Credit Application

Trade References

Bank Reference