625 Dettloff Drive • PO Box 220 • Arcadia, WI 54612 608-323-3366 • 800-356-3320 • FAX 608-323-2185

CREDIT APPLICATION AND AGREEMENT BUSINESS CONTACT INFORMATION

Date:

Company Name: Phone:

Fax:

Primary Company Address:

E-mail:

City:

State:

Zip Code:

City:

State:

Zip Code:

Primary Company Ship to Address: Owner/President: Date Established:

Accounts Payable Contact: Phone:

Bank Name:

PRINTING & GRAPHIC DESIGN

Tax ID#:

Type of Company: ❏ C Corporation ❏ S Corporation ❏ LLC ❏ Partnership ❏ Proprietorship ❏ Other BUSINESS AND CREDIT INFORMATION

Type of Business:

Fax:

E-mail:

Bank Address:

Phone:

City:

State:

Amount of Credit Desired:

Purchase Order Required:

Type of Account: ❏ Checking ❏ Savings ❏ Other

Zip Code:

Account Number: ❏ Yes

❏ No

NOTE: IF YOU ARE TAX EXEMPT, PLEASE INCLUDE A COPY OF YOUR CERTIFICATE WITH YOUR APPLICATION. 1. Company Name: Address: City:

2. Company Name: Address: City:

3. Company Name: Address: City:

BUSINESS/TRADE REFERENCES

Phone:

State:

Zip Code: Phone:

State:

Zip Code: Phone:

State:

Zip Code:

INVOICE AND STATEMENT DELIVERY OPTIONS

How you would like to receive your statements and invoices.

❏ Mail

Fax: Fax: Fax:

❏ E-mail_________________________________________

Invoices are due Net 30 days from the date of invoice to customers with approved credit, unless otherwise specified on the invoice, and in accordance with all other terms and conditions expressed in the invoice. Any invoice not paid per its terms will be designated as a “Past Due Account”, which can cause delivery of shipments to be withheld on any new or outstanding orders. Past Due Accounts may be placed on COD. Buyers authorizes Seller to request credit related information from any source, including trade references, bank references and/or credit reporting agencies or bureaus and further herby permits dissemination of credit information about Buyer from inquiring sources and releases Seller from any likability which may result therefrom. The undersigned is duly authorized to execute this Application of behalf of the Buyer. Everything stated in the foregoing Application is true and correct. Signature_____________________________________Print Name_____________________________________ Title____________________ Date___________________

PERSONAL GUARANTEE: (Delinquent accounts will be placed for collections) In consideration for credit extended, the undersigned contracts and guarantees to the faithful payment, when due, of all accounts of the company seeking credit. The undersigned expressly waives all notice of acceptance of this guarantee, notice of extension of credit, presentment of demand for payment and any notice of default by the company seeking credit and all other notices the guarantor might be entitled to. Revocation of the guarantee shall be in writing and delivered by certified mail. Name___________________________________________ Date_______________

Name____________________________________________Date_______________

ALL ACCOUNTS WILL BE COD UNTIL CREDIT HAS BEEN APPROVED