Credit Application

Credit Application

General Information

Company Name:

Telephone:

Mailing Address:

City:

State:

Zip:

Street Address:

City:

State:

Zip:

Email:

Business Structure:

Corporation

Partnership

Proprietorship

Type of Business:

Distributor

Wholesaler

Retailer

Manufacturer

Federal ID Number:

Date Established:

Insurance Co.:

Credit Line Desired:

Accounts Payable Contact:

Principal Owner(s):

1) Name:
Title:
Soc.Sec#:
Home Address:
City:
State:
Zip:
Home Phone:
2) Name:
Title:
Soc.Sec#:
Home Address:
City:
State:
Zip:
Home Phone:

Financial Information - Suppliers
(List Four)

1) Name:
Address:
City:
State:
Zip:
Phone:
2) Name:
Address:
City:
State:
Zip:
Phone:
3) Name:
Address:
City:
State:
Zip:
Phone:
4) Name:
Address:
City:
State:
Zip:
Phone:

Bank Accommodations:

1) Bank Name:
City:
State:
Zip:
Phone:
Contact Person:
Account Numbers
Checking:
Savings:
Loans:
2) Bank Name:
City:
State:
Zip:
Phone:
Contact Person:
Account Numbers
Checking:
Savings:
Loans:

Important: In consideration of International Diamond Systems, Inc. (hereinafter referred to as International Diamond) extending credit to applicant, the applicant agrees to pay for all materials delivered to or at the request of the applicant by International Diamond, within the terms as stated on invoices for said materials. Applicant understands and agrees that unless otherwise stated on confirmation order payment terms are Net 30. Applicant further agrees that a financial charge of 1-1/2% per month (18% per annum) shall apply to past due items and applicant promises to promptly pay such charges. In the event that International Diamond commences litigation, or employs attorneys in order to obtain payment of any sums due from applicant, the applicant agrees to pay for reasonable attorney fees in addition to all other sums due. The applicant authorizes International Diamond to obtain credit and financial information concerning the applicant at any time from any source.

By submitting this form the applicant warrants that the above agreement has been read and that the applicant understands the content of this agreement. International Diamond reserves the option to reject any application that is not complete or properly submitted.

Submitted by (Officer Required):
Title:
Date: