Minooka Grain Lumber & Supply Company Credit Application Form

Minooka Grain Lumber & Supply Company Credit Application Form
LEGAL BUSINESS NAME
TRADE NAME
BILLING ADDRESS

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
PHONE NUMBER
Please enter a valid phone number.
EMAIL ADDRESS
example@example.com
ACCOUNTS PAYABLE PHONE NUMBER
Please enter a valid phone number.
WOULD YOU LIKE TO RECIEVE INVOICE ELECTRONICALLY?

YESNO
LEGAL OWNER NAME & TITLE
HOME PHONE #
Please enter a valid phone number.
CELL NUMBER
Please enter a valid phone number.
HOUSE ADDRESS

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
TITLE/BANK
TITLE/BANK PHONE NUMBER
Please enter a valid phone number.
TITLE/BANK CONTACT PERSON
REFERENCES
Please include name, number and email.
Someone from our team will call you for your Sales Tax number and Social Security Number.

In consideration of credit being extended by Minooka Grain Lumber & Supply Company to me/us/it/I/we certify that truthfulness and veracity of the statement above and we/I guarantee and bind ourselves to the faithful payment of all amounts purchased & now owing, by us or any other person, firm or corporation for our benefit. In the event this account is placed in the hands of an attorney for collection or suite instituted to collect same or any action, therfore I/we agree & promise to pay attorney fees in full as well as balance due and owing. Purchases and or deliveries are herewith authorized to be made without a signature. Purchase of materials will indicate acceptance of the terms & conditions that will be outlined ons subsequent invoices & statements.

Invoices not paid within thirty (30) days following delivery will be past due and default and a late charge and/or finance charge will be assessed in the amount 1.5% calculated on the last day of the month following the date of delivery (less payments and credits to said balance) until payment made in full

I/WE agree to Terms of Minooka Grain, Lumber & Supply Company.
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