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Credit application

Apply for a Net 30 business account

Approved business accounts buy on Net 30 terms. The application takes about five minutes; you can attach your tax resale certificate at the end.

1Business information

Legal business name DBA / trade name

Business type Federal tax ID (EIN)

Years in business State of incorporation

Industry Website

Billing address Ship-to address (if different)

Sales tax permit / resale certificate # Tax-exempt purchaser?

2Contacts

Owner / principal name Title

Email Phone

Accounts payable contactAccounts payable email

Accounts payable phone Invoices sent by

3Credit requested

Estimated monthly purchases Credit limit requested ($)

Terms requested Purchase orders required?

4Bank reference

We only contact your bank to confirm the relationship. Please don't enter account numbers here.

Bank name Branch city / state

Bank contact / officerBank phone

5Trade references

Three suppliers you currently buy from on terms.

1 Company ContactPhone or email

2 Company ContactPhone or email

3 CompanyContactPhone or email

6Documents Tax resale or exemption certificate (PDF, JPG or PNG, up to 3 MB) Anything else we should know?

7Agreement & signature

By signing, the applicant certifies that the information above is true and complete and authorizes AR Unlimited Supply to verify it with the bank and trade references listed and with commercial credit reporting agencies.

If credit is approved, invoices are due in full within the agreed terms (normally 30 days from invoice date). Past-due balances may be subject to late charges as permitted by law, and the applicant agrees to pay reasonable collection costs and attorney's fees on past-due accounts. AR Unlimited Supply may change or withdraw credit terms at any time. Orders remain subject to our terms & conditions.

I have read and agree to the credit terms above and am authorized to sign for this business.

Authorized signature (type full name) Title

Date