Commercial Credit Application Company InformationCompany Legal Name(Required)Doing business as (DBA), If different from Legal NameAddress(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Email(Required) Phone(Required)Business Start Date Month Day Year Number of EmployeesAnnual SalesType of Entity(Required) Corporation Government LLC/Limited Liability Partnership General Partnership Sole Proprietorship Other Principals/OwnershipIncludes Officers, Partners, Directors, or ProprietorList(Required)NameTitleOwnership Add RemoveParent CompanyCompany's Legal NameDoing business as (DBA), If different from Legal NameAddress Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Email PhonePublic FilingsHas the Applicant, or any principals involved in the company, ever filed for protection under bankruptcy laws? Yes No Bank References(include deposit accounts and loans/lines of credit, if applicable)Bank ReferencesBank NameContact Person and EmailAddressTelephoneAccount Number Add RemoveTrade ReferencesVendor's NameVendor's NameContact Person Name and EmailAddressAccount Number Add RemovePurchasing InformationTax Exempt CertificateAccepted file types: pdf, doc, docx, jpg, png, Max. file size: 50 MB.All commercial customers must supply a tax-exempt certificate or a tax certificate before orders can be processed.Requested Credit LimitPersonal Guaranty(ies)For All Customers Requesting Credit Lines Exceeding $5000.Name First Last Date of Birth Month Day Year PhoneSignatureTerms & Conditions(Required) By clicking the submit button, I agree to terms & conditions.FINANCIAL ACCOUNT AGREEMENT All Shipments are FOB Coeymans, NY 12045 All standard terms are Net 30 days Once a shipment leaves our facility the ownership transfers and all freight loss or damage is the responsibility of the purchaser. We reserve the right to change container shape or size or color without prior notifications. All prices are subject to change TERMS AND CONDITIONS 1. CORRECTNESS OF INFORMATION. By submitting this form, you affirm that the information provided herein are true and correct. Any misrepresentation or incorrect information found by the bank shall be cause for denial or rejection of the loan. 2. LOAN INTEREST. The Borrower shall pay the loan in one year with the interest rate of twelve percent (12%) per annum in equal monthly installments to be paid on every fifteenth (15th) day of every month. The interest rate shall be paid on the final payment of the loan period. 3. LATE PAYMENT. Late payments made by the borrower every month shall incur late payment charges of three percent (3%) of the installment amount. 4. ADVANCED PAYMENTS. The Borrower may pay the installments in advance or pay the loan in full at any time. 5. INSURANCE. The Borrower shall pay for the insurance of the loaned amount 6. PAYMENT OF LOAN METHOD. The Borrower shall make payments under this loan either in cash, check, or any negotiable instrument to any branch of the bank. 7. DISPUTES IN CASE OF BREACH. In case of dispute, claim, or controversy arising due to breach of this agreement, the parties may submit to arbitration chosen by both parties. The parties shall divide the cost and expenses to the proceeding in equal shares. Further, the losing party shall pay the cost of attorney’s fees of the prevailing party, other than the dispute award. 8. CONFIDENTIALITY. Any information that the bank may acquire through the course of this agreement shall be recognized as Confidential Information. The bank shall keep confidential the confidential information and shall exercise the same degree of care required by law. 9. SEPARABILITY CLAUSE. Should any provision of this Agreement be held invalid by any competent court, the same shall apply only to the provision involved and the remaining provisions hereto shall remain valid and enforceable. 10. AGREEMENT MODIFICATION. Any modifications or alterations to this agreement shall only be considered as agreed by the parties in the existence of a written document signed by both parties. 11. COUNTERPARTS. This agreement may be executed in two or more counterparts each of which shall be deemed an original and all of which together shall constitute one and the same agreement. 12. GOVERNING LAW. This agreement shall be governed by and construed in accordance with and only of the laws of the State of California. 13. RELATIVITY. This agreement inures to the benefit of, and is binding upon the successions and assigns of the parties hereto. 14. NON-WAIVER. The failure of any party to insist upon the strict compliance with and performance of any of the terms, conditions, and covenants shal not be deemed as a waiver of said party may have over such breach. Only by expressed written consent and duly signed by the parties may a proper waiver be considered as having been made.
