Credit Application

Date
MM slash DD slash YYYY
Name
First Last
ADDRESS
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Fax
Cell
Years in Business
I am applying for a...*
- Individual account
- Business account

Individual Account
Employer
Phone
Occupation
Years Employment
Business Account
Ownership
- Corporation
- Partnership
- Proprietorship
Owner(s) Name(s)
Description of Business
Do you use PO Numbers or Job Names
- PO Numbers
- Job Names
If Contractor - Are Jobs Bonded?
- Yes
- No
Bond #
Bonding Agency
Bonding Agency Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Contractor's License Number
NOTE: If your purchases are for resale, be sure to send the new Washington State Reseller Permit.

BUSINESS REFERENCES
(Give only names of those you buy from on an open account)
Reference 1
First Last
Reference 1 Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Reference 1 Phone
Reference 2
First Last
Reference 2 Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Reference 2 Phone
Reference 3
First Last
Reference 3 Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Reference 3 Phone
Reference 4
First Last
Reference 4 Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Reference 4 Phone
Reference 5
First Last
Reference 5 Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Reference 5 Phone

Authorized Persons
Names of persons authorized to charge on this account
Are these persons authorized to charge tools?
- Yes
- No
Resaon for wanting to open an account with us
We we recommended to you by a customer or relative?
- Yes
- No
If so, by whom?
Your estimate of the dollar amount you expect to purchase from us per month
Reseller Permit*
If you will be reselling these products, please upload your reseller permit.
Max. file size: 1,000 MB.
Corporate Guarantee
The undersigned being an Officer/Director/Shareholder of the Applicant Corporation do hereby agree to the following terms and conditions and assume personal responsibility for payment of said corporation's account, and guarantee in full that the said account will promptly be paid. It is understood that credit would not be extended to said corporation without this assumption of liability and guarantee.

Notice: The following is provided for your information. Please read the credit plan and do not submit this application before you do so.
1. To pay each invoice by the tenth of the following month.

2. To pay a 1.5% service charge on any invoices past due.

3. To pay attorney's fees in the event that collection efforts become necessary.
CAPTCHA

Individual Account