Oware

THIS FORM MUST BE TYPEWRITTEN OR PRINTED

Upon completion return original application to David A. Olsen

APPLICANT

(Company Name)___________________________________________________________________

ADDRESS/CITY/STATE____________________________________________________________

_________________________________________________________________________________

TELEPHONE( )_________________________YR. STARTED____________________________

TYPE OF BUSINESS____________________ CORP_____ / PRTNRSHP____________________

OWNERS NAMES (if individual, partnership or joint venture include names, addresses and S.S.N. of owners and principals)(If corporation, please list names of all officers)

OWNERS / PRINCIPAL/PRESIDENT/V. PRESIDENT/SEC./TREAS.

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

SOCIAL SECURITY # ______________________ / RESALE #____________________________

TRADE REFERENCES

1.______________________ 2.____________________ 3.____________________

________________________ ______________________ ______________________

________________________ ______________________ ______________________

Phone:__________________ Phone:_________________ Phone:_________________

BANK REFERENCE

Bank Name:_________________________________________ Acct. #:__________________

Address:____________________________________________ Officer:__________________

City/State/Zip:_______________________________________ Phone:___________________

All statements made herein are true and accurate to the best of my knowledge. I hereby authorize David A. Olsen his agents and employees, to make any an all inquiries necessary to determine whether or not to extend credit on the basis of this credit application. The undersigned hereby agrees to indemnify and hold harmless David A. Olsen and his agents from any liability, damages, claims, court costs and attorneys fee resulting from a credit investigation.

In consideration of the extension of credit by David A. Olsen the undersigned hereby agrees to promptly pay all invoices for merchandise and services purchased by the undersigned in accordance with the terms expressed on the invoice. In the event payment is not made in accordance with the terms of credit set forth on the invoice, the undersigned agrees to pay a late charge of 1.5% per month commencing the the transaction date.

In the event that any suit or action is instituted to collect any amount due under our account, the undersigned hereby agrees to pay, in addition to the amount owed, all legal fees incurred, including a reasonable sum for attorney's fees at trial or on appeal. The undersigned also agrees to pay any collection agency fees or court costs that may be incurred to collect monies due.

 

Authorized signature:_____________________________Date:__________________________

 

Print name:_____________________________Title:__________________________________

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