Beeson Hardware Company Inc.
Credit Application
Name of Applicant Trade Name, if any
Mailing Address
 City
 State
 Zip
Shipping Address
 City
 State
 Zip
Country  

Type of Business: Contractor Industrial Group Other 		Home Address

Business is: Corporation Partnership Proprietorship Other
Description of Business
Date Business Commenced
 		Annual Sales
 		No. of Employees
Business Phone Number
 Fax Number
 Home Phone
If Division or Subsidiary: Name of Parent Company
Estimated Amount of Monthly Purchases
List the name(s) and location of owner(s) or Principal(s) if Corporation
Name

Name
 Address
Address
 Title

Title
If Proprietorship List S.S. Number / License
If Corporation List Fed Tax ID Number State in which Incorporated
Will Purchase Orders be Issued? Yes No
If yes, Name of Person(s) Authorized  Title
            Name of Person(s) Authorized Title
            Name of Person(s) Authorized Title
Does the applicant pay by Invoice Statement        Do you want a monthly statement? Yes No
Does the Applicant pay sales tax? Yes No        If no please submit the appropriate approved certificate.
According to state law we are liable to charge and collect tax unless the state approved form is submitted.
Also, list state tax number.
Is firm listed and rated by Dunn and Bradstreet? Yes No             If yes give rating
Were any of the principals in business before? Yes No
If yes, give name and location of business
If not, reason for discontinuing
Has the applicant been declared bankrupt in the last 14 years? Yes No    If yes, where? Year?
Are there any pending lawsuits or unsatisfied judgments against your firm? Yes No
Is the applicant's location or building Owned Rented Leased
Are any of the applicant's assets pledged as collateral? If so, please indicate which assets and to whom.
 
Please Provide Latest Financial Statements Available
Bank with Bank Address
Account number Account Name
 
List four (4) trade references (excluding banks)
 
Personal Guaranty
The undersigned for, and in consideration for extending credit at my request to (herein referred to as "COMPANY"), hereby personally guarantees the payment, when due, to BEESON HARDWARE COMPANY INC, or it's successors in interest, of any obligation of the COMPANY whenever the COMPANY shall fail to pay the same. It is understood that this guaranty shall be a continuing and irrevocable guaranty and indemnity for such indebtedness of the COMPANY. I do hereby waive notice of default, non-payment, and notice thereof and consent to any modification and renewal of the credit agreement hereby guaranteed. I understand that to terminate this guaranty notification must be in writing and sent via certified mail.
 
Name (Printed)   Signature_______________________________  Date
Address and telephone number
Witness Date S.S. Number
 
Officer / Owner: Please Read Carefully and Sign

The person, corporation, or firm whose name appears on the credit application, and to whom an open line of credit is extended, will be notified in writing, advising of the amount of credit extended. All applications approved for credit are governed by the following:

1. The information contained in this credit application is true to the best of my knowledge. Permission is granted as evidenced by me (our) signature(s) below, for Beeson Hardware Company, or it agents, to contact the references listed on this application or any other source for the purpose of obtaining credit information. The creditor, bank, or lending institution contacted has my (our) permission to furnish Beeson Hardware Company with any and all information requested.

2. Beeson Hardware Company will have no obligation to make any shipments on any account, on an open basis that will cause an account to exceed the established line of credit.

3. If an account reaches 60+ days past due, orders are subject to hold until the account is current.

4. A service charge of I l/2% per month will be charged on the past due balance.

5. A $20.00 handling charge is assessed to checks returned marked NSF.

6. Payments will be made in accordance with terms so stated.

7. In the event of non-payment and the institution of legal proceedings, the person, firm, or corporation to whom open account was extended agrees to pay Beeson’s reasonable attorney’s fees.

8. Applicant will give advanced notice to Beeson Hardware Company of any change in the business structure. In other words, corporation, changes of ownerships, etc. Without such notice, the original principal, to whom credit was extended shall remain liable. Notice is to be given by certified or registered letter and acknowledged by return receipt.

9. Credit policies are subject to change at the discretion of Beeson Hardware Company management. Upon acceptance of this application, and the issuance of as open line of credit, THE APPLICANT agrees to abide by the credit policies of Beeson Hardware Company.

 
Name of Applicant (Please Print)

Signature of (Officer, Owner, or Partner)________________________________________________________

Title Date
 
 

Mail to:
Credit Manager
PO Box 1390
High Point, N.C. 27261