Credit Application

Avimo Foods, LLC Credit Application

All parts of this application must be completed by any new customer. In the event of any changes to ownership, company name, or company legal entities please notify Avimo Foods LLC.
Company Information
Business Name
Doing Business As (DBA Name)
Business Type
Legal structure
Tax ID #
Sale Permit #
Phone Number
Please enter a valid phone number.
Email
example@example.com
Account Payable Contact

First NameLast Name
Phone Number
Email
example@example.com
Business Address
Street Address Address Line 2 City State Zip
Delivery Address
Street Address Address Line 2 City State Zip
Bank Reference Information
Bank Name
Checking Account #
Contact Name
Phone Number
Contact Email
example@example.com
Trade References
Company Name
Contact Name
Phone Number
Contact Email
example@example.com
Company Name 2
Contact Name
Phone Number
Contact Email
example@example.com
Company Name 3
Contact Name
Phone Number
Contact Email
example@example.com
General Information
Credit Limit requested
Payment Terms Requested
Sale Rep Name
Principal / Guarantor Information
Principal Full Name

First NameLast Name
principal Title
Principal Number
Principal Email
example@example.com
Principal Social Security Number
The above Confidential information is submitted solely for the purpose of opening an account with Avimo Foods LLC. By siging you authorize Avimo Foods LLC. to check credit and to receive information regarding the credit of the listed company/companies and bank experience. You also certify that the above information is true and correct and accept the terms of sales as stated.Terms and condtions of Sales: $35 for each returned check. Interest charge of 1.5% per month (18% per year) will be applied to past due accounts
I agree to the terms and conditions specified above
Signature*

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Avimo Foods, LLC Credit Application

Company Information

Bank Reference Information

Trade References

General Information

Principal / Guarantor Information