Credit Application

CREDIT APPLICATION

Must be filled out completely
Please select the Hank's Specialties branch you're most likely visit:*

New Brighton, MNEagan, MNPlymouth, MNRochester, MNSt. Cloud, MNDuluth, MNFargo, NDBismarck, NDMadison, WIEau Claire, WILa Crosse, WIUrbandale, IADavenport, IACedar Falls, IACedar Rapids, IAOmaha, NELincoln, NESioux Falls, SDRapid City, SDGreen Bay, WI
Name*

First NameLast Name
Email*
Phone # *

Area CodePhone Number
Billing Address*

Street Address

Street Address Line 2

CityState

Zip Code
Shipping Address (if different than Billing Address)

Street Address

Street Address Line 2

CityState

Zip Code
The capacity in which you will be doing business with us:*

IndividuallyCorporationPartnershipLLCLLPOther
Firm's Full Legal Name (if different from above)
If a corporation, LLC or LLP, approx. date of formation:

MonthDayYear
Date
Owner/Member*

First NameLast Name
Title*
Owner/Member

First NameLast Name
Title
Owner/Member

First NameLast Name
Title
Do you belong to a buying group?*
Has any judgement ever been entered against any of the companies or principals listed above?*
Have any of the companies or principals listed above ever been a debtor in a bankruptcy proceeding?*
Are there any legal actions or arbitration pending against any of the companies or principals listed above?*
Type of Business*
Are you Tax Exempt? (If yes please give your Tax Exempt number below and upload a copy of your certificate)*

YesNo
Number of Employees*
Tax Exempt Number
Years in Business*
Please upload a copy of your State Tax Exempt Certificate

Browse Files

Cancelof
Accounts
Principal Bank*
Contact Name*
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*

Area CodePhone Number
Checking Account #
Savings Account #
Loan Officer's name
Credit References - Open Accounts Only

To ensure faster response, please include the Fax number of the reference provided
Bank or Creditor's Name*
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone # *

Area CodePhone Number
Fax #

Area CodePhone Number
Email
Bank or Creditor's Name
Address

Street Address

Street Address Line 2

CityState

Zip Code
Phone #

Area CodePhone Number
Fax #

Area CodePhone Number
Email
Bank or Creditor's Name
Address

Street Address

Street Address Line 2

CityState

Zip Code
Phone #

Area CodePhone Number
Fax #

Area CodePhone Number
Email
Bank or Creditor's Name
Address

Street Address

Street Address Line 2

CityState

Zip Code
Phone #

Area CodePhone Number
Fax #

Area CodePhone Number
Email
I/we warrant the information shown in the application to be true and authorize Hank's Specialties. I/we authorize Seller from time to time to obtain Business and Consumer Credit Reports on Customer or any principals listed above or to obtain credit and funding information for any other source.

I/we agree to notify in writing of any change in the capacity in which I/we do business, i.e., individual, partnership, corporation, LLC or LLP. Until such notice is given, Hank's Specialties may presume that I/we still do business in the capacity that I/we set forth in this application and all contracts entered into prior to any receipt of change, shall be binding upon me/us in such capacity. Further, I/we understand and agree that I/we shall have the burden of proving if and when such notice received.

I/we also agree to pay a service charge of 18% per year (equaling 1 1/2% per month) on the accrued, unpaid balance of any bill which is not paid in full within thirty (30) days. The service charge will be applied to the outstanding balance at the end of each monthly billing cycle. There is a minimum service of $2.00 per month if any bill has not been paid in full within thirty (days Hank's Specialties may modify the percentage of interest charged from time to time up to the highest amount allowed by law, and I/we agree to pay assessed interest as modified up to the highest legal amount.

If my/our account must be placed with an attorney for collection, whether a lawsuit is filed or otherwise, or if the services of an attorney are required to protect our interest, I/we do agree to pay all collection costs, including reasonable attorney's fees. "Reasonable attorney's fees" include, but are not limited to, 33 1/3% of the outstanding balance of principal and accrued interest.

Customer expressly agrees to submit to personal jurisdiction in Minnesota and agrees that the forum for any litigation pursuant to this Agreement or any other contract between Seller and Customer, whether Seller or Customer brings suit, shall be the County of Ramsey, Minnesota. This Agreement shall be governed by and construed in accordance with the laws of Minnesota.
Amount of Credit Requested*
Authorized Signature*

Clear
Name*

First NameLast Name
Title*
Social Security #*
Person in charge of Accounts Payable*
Daytime Phone #*

Area CodePhone Number
Email Address*
example@example.com
To whom it may concern, please consider my signature above as written permission for you to release to Hank's Specialties such information as is necessary for them to extend the above named firm or individual a commercial line of credit.
Hank's Terms: 2% 10 days; net 30 days, (unless specified on the invoice)

CREDIT APPLICATION NOT ACCEPTED WITHOUT APPROVAL OF SELLER'S CREDIT DEPARTMENT
Personal Guaranty

To be completed by customers applying as a corporation, LLC, or LLP, if such corporation, LLC, or LLP has been formed within the last three (3) years.
In consideration of Hank's Specialties, hereinafter called The Seller, supplying goods and services for and on behalf of, or at the request of, the corporate entity whose authorized representative has executed this agreement, hereinafter called The Buyer, the undersigned jointly and severally hereby personally guarantee to the Seller the payment of any sums now owing and all sums to become due the Seller thereafter for goods and services provided or performed for said Buyer or at the request of the Buyer, said sums shall include accrued interest, collection costs and reasonable attorney's fees, if any, whether said sums are owing or become due under contract or an open account, and the undersigned waives demand for payment and notice or non-performance and non-payment.
Name of Corporation, LLC, or LLP
Address

Street Address

Street Address Line 2

CityState

Zip Code
It is expressly understood by all the parties hereto that if HANK'S SPECIALTIES extends credit to the above named Buyer, it does so in reliance upon this guaranty as well as the present financial strength of the Buyer.
NOTE: Signature of owners required below.
Authorized Signature

Clear
Authorized Signer

First NameLast Name
Title
Authorized Signature

Clear
Authorized Signer

First NameLast Name
Title
Date Signed

MonthDayYear
Should be Empty:

CREDIT APPLICATION

Accounts

Credit References - Open Accounts Only

Personal Guaranty