Clone of Credit Application for a Business Account

Credit Application for a Business Account

Provide your business, banking, trade reference, and guarantor details, then review and agree to the terms before submitting.
Business Contact Information
Your Name

First NameLast Name
Company Name
Your Title
Your E-mail
example@example.com
Business Phone
The best number to reach you during the work day.Format: (000) 000-0000.
Primary Business Address

Street Address

Street Address Line 2
CityStateZip Code
Building Is
Is your registered company address the same as the above "Primary Business Address"?
Registered Company Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Date Business Commenced

MonthDayYear
2 digit month, 2 digit day, 4 digit yearApproximate Date OK
Federal EIN Number or Tax ID Number
D&B DUNS Number
Business Structure

Other
Tax Exempt
Resale Certificate Upload

Cancelof
Business and Credit Information
A/P Contact Name
A/P Telephone
Please enter a valid phone number.Format: (000) 000-0000.
A/P Fax
Please enter a valid phone number.Format: (000) 000-0000.
A/P E-mail
example@example.com
Bank Name
Bank Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Bank Phone
Please enter a valid phone number.Format: (000) 000-0000.
Type of Account
Account Number
Type of Business
Business/Trade References
Reference 1 - Company Name
Reference 1 - Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Reference 1 - Phone
Please enter a valid phone number.Format: (000) 000-0000.
Reference 1 - Fax
Please enter a valid phone number.Format: (000) 000-0000.
Reference 1 - E-mail
example@example.com
Reference 1 - Type of Account
Reference 2 - Company Name
Reference 2 - Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Reference 2 - Phone
Please enter a valid phone number.Format: (000) 000-0000.
Reference 2 - Fax
Please enter a valid phone number.Format: (000) 000-0000.
Reference 2 - E-mail
example@example.com
Reference 2 - Type of Account
Reference 3 - Company Name
Reference 3 - Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Reference 3 - Phone
Please enter a valid phone number.Format: (000) 000-0000.
Reference 3 - Fax
Please enter a valid phone number.Format: (000) 000-0000.
Reference 3 - E-mail
example@example.com
Reference 3 - Type of Account
Personal Guaranty
GUARANTY

In consideration of the credit which has been or which may in the future be extended to Applicant, and pursuant to the Terms and Conditions contained in the Credit Application and Agreement, each undersigned hereby personally guarantees the prompt and full payment of all amounts now or hereafter owing by Applicant to Rapid HVAC Parts. Each of the undersigned further agrees that the foregoing guaranty is continuing, absolute and unconditional and may be enforced against any of the undersigned individually, jointly or in any combination, without first proceeding against Applicant. Each of the undersigned waives any right to be released by reason of any of time or change in terms of payment and any other defense now or hereafter available except the defense of payment.

By signing below, each undersigned individual acknowledges that he/she has read the Rapid HVAC Parts Terms and Conditions of Sale, understands that these Terms and Conditions have legal consequence both to the Applicant and to the undersigned individually, and agrees to be legally bound thereby. Your typed or drawn signature below constitutes your electronic signature.
Guarantor Signature
Print Name and Title
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Second Guarantor Signature
Print Name and Title
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

Credit Application for a Business Account

Business Contact Information

Business and Credit Information

Business/Trade References

Personal Guaranty