GameGuard Credit Application

GameGuard Credit Application
Legal Business Name*
Year Established*
Billing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Individual OwnerPartnershipCorporation
State of Incorporation
Texas Resale Number
Owner or Officer*

First NameLast Name
Owner or Officer Title*
Owner or Officer Telephone No*

Area CodePhone Number
Owner or Officer Email*
Owner or Officer Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Accounts Payable
Contact Name*

First NameLast Name
Email Address*
Telephone No*

Area CodePhone Number
Banking Information
Bank Name*
Account No*
Bank Officer*

First NameLast Name
Email Address*
Telephone No*

Area CodePhone Number
Bank Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Trade References ( three references required)
Vendor*
Account No*
Contact Email*
Contact Fax

Area CodePhone Number
Trade Reference
Vendor*
Account No*
Contact Email*
Contact Fax

Area CodePhone Number
Trade Reference
Vendor*
Account No*
Contact Email*
Contact Fax

Area CodePhone Number
We hereby apply for credit and affirm financial responsibility, ability and willingness to pay Invoices in accordance with Creditor's published terms. The above information, as well as the attached financial statement, is warranted true, correct and complete. We hereby authorize you to verify and collect information on us, including but not limited to, bank references, trade references, consumer and/or commercial credit reports. We agree to pay a monthly finance charge of the maximum applicable state rate on all past due balances. We agree to pay all costs of the collection including reasonable attorney's fees on this account in accordance with the laws of the creditors's state of incorporation. We agree that all decisions, with respect to the extension or continuation of credit, shall be at the sole discretion of the Creditor. We further acknowledge and agree that in the event we have ordered customized products from the Creditor, and for any reason cancel such order, we are responsible for all the costs of the artwork incurred in the development of said custom products as well as any products for which customization has been completed.
I have read and agree to the Terms and Conditions outlined above
Authorized Signatory*
Date*

MonthDayYear
Should be Empty:

GameGuard Credit Application

Accounts Payable

Banking Information

Trade References ( three references required)

Trade Reference

Trade Reference