Customer Credit Application

Owner/Officer Name *

Officer's Phone *

Officer's Email *

Company Name #1 *

Account Number *

Years Doing Business *

Contact Name, Email & Phone *

First

Last

Phone *

Company Name #2 *

Account Number *

Years Doing Business *

Contact Name, Email & Phone *

First

Last

Phone *

Company Name #3 *

Account Number *

Years Doing Business *

Contact Name, Email & Phone *

First

Last

Phone *

Terms and Conditions

For the purpose of establishing this account, I consent to have WNL Products make the usual credit check with each trade reference as well as the bank reference, when applicable. I further agree that upon default in payment, to pay in addition to all outstanding invoices, all collection costs including attorney fees and legal expenses, plus interest at a rate of 1.5% per month (18% per annum) from the date of default on the outstanding invoices.

Digital Signature (by typing my name below I consent to the above agreement) *

Title *

Email *

Date *

PLEASE INCLUDE A COPY OF YOUR RE-SALE OR TAX EXEMPT CERTIFICATE ALONG WITH THIS APPLICATION

Click or drag files to this area to upload. You can upload up to 10 files.

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