APPLICATION FOR CREDIT
Phone: 724/548-8101 Fax: 724/545-2989
Please Type in the Form, Print, then Mail or Fax (Signature Required)
Allegheny Mineral Corporation    Glacial Sand & Gravel Co.
     
GENERAL INFORMATION
Date: (mm/dd/yy)  
Company:
Address:
Street Address:
City, State, Zip:
Phone w/Area Code: 
Type of Entity: Corporation Partnership Proprietorship
Year Established:
Associated Companies or Former Business Name:
   
FINANCIAL  
Taxable:  Yes No (if No, send tax exemption certificate)
Bank Name: Account No: 
Phone:    
Bank Name: Account No: 
Phone:    
Bank Name: Account No: 
Phone:    
Bonding Company:
Bonding Co. Agent:
Phone:
 
OFFICER/OWNER  
Name & Title
Home Address
City, State, Zip
Phone
Social Security Number
Name & Title
Home Address 
City, State, Zip
Phone
Social Security Number
 
TRADE REFERENCES
Please list Name, Address, and Phone:
 
I, We the below undersigned, do acknowledge and accept that all invoices are due and payable according to the invoice terms.   Interest will be charged on all invoices not paid by the 30th day after the invoice is due and payable, at the rate of eighteen (18%) percent, per annum, unless such interest ever exceeds the maximum rate allowable under  applicable State or Federal law, and in such event, interest will be charged at the maximum allowed rate.  It is expressly agreed that all obligations of the parties created herein are performable in the county of the office indicated above.  The applicant expressly represents that the goods purchased herein are not intended for personal, family, household, or agricultural use.     If this applicant is place for collection with an attorney, the applicant and its guarantors shall be liable for reasonable attorney's fees.   Supplier is authorized to investigate and obtain reports regarding this application or resulting account with credit reporting agencies and others, including personal guarantors.  This account is subject to the terms and conditions  as stated on the delivery tickets, invoices, and this Credit Application.
 
Signature: (Officer & Title)     
Date: (mm/dd/yy)
 
In consideration of goods being sold on open account to the above-named firm, I personally guarantee all indebtedness hereunder.  I further agree that this guarantee is an absolute, completed and continuing one, and no notice of the indebtedness already or hereafter contracted need be given.  The terms may be rearranged, extended and/or renewed without notice to me.  That I will, within five (5) days from the date of  notice that the account is past due, pay the amount due.
 
Signature: (Guarantor)
Date: (mm/dd/yy)   
 
 

 Back to Credit App Page

 

All rights reserved. Copyright © 1997-2002 Snyder Associated Companies, Inc.
Web Maintenance:   Cathy George
 Any Problems with this site may be reported to the Webmaster