**Any financial statement with this application will facilitate the establishment of your account and will be relied upon by Card Issuing Company. Any such statements will be kept strictly confidential.
Permission is herewith granted to investigate credit worthiness and to obtain credit information from all listed references including my bank and other credit reporting agencies. I assume personal and individual responsibility and liability, and guarantee of all charges due and payment to Card Issuing Company by the company or corporation listed here-in. I hereby consent and authorize the use of my consumer credit report in the credit evaluation process. All financial information submitted in support of this new account and credit application is true and complete in all respects. My account is subject to a late charge of 2% per month (24% per annum) on all past due invoices. Furthermore, I understand that my account may be turned off if my account is past due and that any collection fees (including attorney fees) incurred by Card Issuing Company, which the parties hereby fix at 33 1/3% of any balance due plus court costs, will be borne by my account. By signing this credit application and using services of Card Issuing Company, I certify that I am authorized to make this request on behalf of this company, and it is agreed that all purchases will be paid in accordance with the terms & conditions.