Become A Customer

Legal Business Name*

Mail Address*

Ship Address*

Business Type*

Officers and/or Owners

Person Responsible for Payments

Name*

Phone *

Email for invoice*

Person Responsible for Purchases

Name*

Phone *

Email for Order Acknowledgments *

Bank - Credit Reference

Name of Bank*

Contact*

Address*

Phone*

Email*

Business References

Reference 1

Company Name*

Contact Name*

Phone *

Email*

Reference 2

Company Name*

Contact Name*

Phone*

Email*

UNCUT MOUNTAIN SUPPLY’S TERMS: Wholesale orders,terms are Net 30 days from ship date. When an invoice purchased in onemonth isn’t paid by the end of the next month, a late penalty of 2% per month (24% per year) will be assessed on the past due balance. Applicant will be liable for all collection costs including reasonable attorney fees in collecting any past due balance and applicant agrees that suit or legal action to enforce this agreement may be brought in the State of Michigan, County of Wexford.

Name*

Title*

Email*

Personal Guarantee

In consideration for credit extended or to be extended to the above company, I/We do hereby agree, individually/ jointly, to guarantee payment of the indebtedness of the company. The undersigned expressly waives all notice of acceptance of this guarantee, notice of extension of credit, presentment of demand for payment, any notice of default, and all other notices the guarantor might be entitled to. This guarantee shall inure to the benefit of and bind the heirs, administrators, executors, successors, or assigns of the parties hereto.

Signature*

Name of Guarantor *

Date

DayMonthYear

Tax Exemption

Download the Tax Exemption Form and attached it to your application to file for tax exemption.

Upload Tax Exemption

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