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Credit Application


Applicant Name: Email:
Company Name:
Phone: Fax:
Owner Name: Tax ID #:
Billing Address:
City, State & Zip:
Shipping Address:
City, State & Zip:
Bank Reference:
Name of Bank: Account #:
Phone: Contact:
Address:
City, State & Zip:
Trade Reference:
1. Name of Business: Phone:
Contact: Fax:
Address:
City, State & Zip:
2. Name of Business: Phone:
Contact: Fax:
Address:
City, State & Zip:
3. Name of Business: Phone:
Contact: Fax:
Address:
City, State & Zip:
TERMS AND CONDITIONS;
1. All amounts not paid as agreed herein shall accrue interest at the rate of 1-1/2% per month (18% per annum) or the hightest rate permissible by law, whichever is less.
2. Applicant agrees to pay a service charge of U$50.00 for each check returned unpaid.
3. In the event of default in payment of any amount due hereunder, and if the account is placed with an outside attorney for collection, Applicant agrees to pay all reasonable collection costs, attorney fees and court costs.
4. No returns will be accepted without prior authorization.
The above information is for the purpose of obtaining credit from DIAMAT and is warranted to be true. I authorize DIAMAT to investigate the above references and to obtain credit information from them. I agree to the terms and conditions of sale as stated above. Should a credit availability be granted by DIAMAT, all decisions with respect to the extension or continuation should be in the sole discretion of DIAMAT. DIAMAT may terminate any credit availability at any time within its sole discretion.
    

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