New Customer Credit Application Form

New Customer Credit Application Form
Julius Meinl North America LLC

Phone: 844-316-7662 Ext: 3| Email: Accounting.US@meinl.group
Sales manager*
SM email
example@example.com
Location Name (Ship-to)*
Location Address*

Street Address

Street Address Line 2

CityState

Zip Code
Business Contact Information
Legal Company Name*
Federal Tax ID Number (EIN)*
DBA (if applicable)
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Contact Name*

First NameLast Name
Phone Number*
Email*
example@example.com
In business since:*

MonthDayYear
Date
Type of Business*

Sole ProprietorshipPartnershipLimited LiabilityCorporation (C-Corp)S Corporation (S-Corp)Other
Resale certificate and Tax exemption
Julius Meinl North America LLC exempts sales tax only upon receipt of a valid, up-to-date resale certificate. If no valid certificate is provided or maintained, applicable sales tax will be invoiced, and your business is obligated to pay such taxes.
Description of Resold Items (choose ALL applicable)*

coffee, tea, cocoacups/lids to gowater filters, spare partsequipmentre-rentwe do not resale any of these itemsOther
Resale certificate number
Technical Number
Please provide a fully completed and signed Illinois CRT-61 Resale Ceritificate. We do not accept the REG-1 registration as a valid exemption document. You can download the required CRT-61 form here: CRT-61 form.
Resale Certificate

Cancelof
By submitting this resale certificate:
- I confirm the above goods are purchased solely for resale in the ordinary course of business.
- I agree to provide an updated certificate if my permit expires or business changes.
- I understand that if my resale certificate is invalid or lapses, sales tax will be charged if required by law.
- If no resale certificate is provided, sales tax will be added to invoices.

- By choosing "we do not resale any of these items" you elect to tax all items we sell you, even other products above were checked.
As we are not currently eligible to collect sales tax in your state, your account will not be charged tax. Your certificate is on file and will be applied automatically if our status changes.
Owner / Officer / Management Contacts
Contact 1
Name*

First NameLast Name
Title*
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Contact 2
Name

First NameLast Name
Title
Email
example@example.com
Phone Number
Please enter a valid phone number.
Account Payables
Name*

First NameLast Name
Email for Invoicing*
example@example.com
Email for Statements*
example@example.com
Phone Number*
Please enter a valid phone number.
Inquired payment method*

Bank-to-Bank TransferPay by linkcredit card on file 2% surchargeCheckACH autopay
To pay by link, authorize ACH autopay or file the credit card details use the link https://juliusmeinlpay.com/
To pay by check mail to

Julius Meinl

P.O. Box 919929

Orlando, FL 32891-9929

in the check memo include invoice #
Inquired payment method is not guaranteed and is subject to credit approval.
Primary Order contact information
Name*

First NameLast Name
Email for Orders*
example@example.com
Phone Number for Orders*
Please enter a valid phone number.
Business/Trade References
References List of the 3 Businesses
Agreement, Authorization and Personal Guarantee
I/We authorize Julius Meinl North America LLC to obtain credit and financial information from the above references for the purpose of establishing a line of credit. I/We certify that the above information is correct and agree to abide by your standard terms and conditions of sale, which include payment terms of 3 days from invoice date unless otherwise stated in writing.

In consideration of credit being extended by Julius Meinl North America LLC to the above-named business for merchandise or services to be purchased, the undersigned personally guarantees payment for all amounts due to Julius Meinl North America LLC by the applicant named herein.This guarantee includes payment and/or return of all equipment associated with the account.

I/We hereby personally guarantee all indebtedness now due or which may become due by the business. This guarantee shall be continuing and shall not be revoked except by written notice to Julius Meinl North America LLC, and such revocation shall not affect my/our obligation as to any indebtedness existing prior to receipt of such notice.
Guarantor’s Full Name*

First NameLast Name
Title*
Home Address*

Street Address

Street Address Line 2

CityState

Zip Code
Guarantor’s Phone Number*
Please enter a valid phone number.
Date*

MonthDayYear
Date
Guarantor's Email *
example@example.com
By signing below, you agree to use an electronic signature legally equivalet to a handwritten signature under applicable law.

Under the Electronic Signatures in Global and National Commerce Act (ESIGN) and the Uniform Electronic Transactions Act (UETA), electronic signatures—including those created by typing a name, drawing a signature with a mouse—are granted the same legal status as handwritten signatures in all U.S. states.
Guarantor’s Signature*

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New Customer Credit Application Form

Business Contact Information

Resale certificate and Tax exemption

Owner / Officer / Management Contacts

Contact 1

Contact 2

Account Payables

Primary Order contact information

Business/Trade References

Agreement, Authorization and Personal Guarantee