Application for Net 30 Day Billing Terms ($150 Minimum Per Order)

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The following information has been read and verified as correct by the undersigned.

• Your standard credit sheet may be attached as long as it contains basically the same information. Signature must appear on this form to be considered for terms.

Date:

 

Billing Information:

 Shipping Information (if different):

Company Name:

Billing Address:

City:

State:

Zip:

Phone:

Fax:

eMail:

Company Name:

Physical Shipping Address:

City:

State:

Zip:

Phone:

Fax:

eMail:

For more than one shipping location attach additional sheets or include with eMail.

Ownership:

Corporation Partnership Individual

Other (Describe):

Social Security Number of Undersigned:

Year Business Established:

NV State Resale # if applicable:

Federal I.D.# if a Corporation:

Description of Business:

Authorized Individuals:

Authorized Buyer 1:

Position:

Phone Ext:

eMail:

Authorized Buyer 2:

Position:

Phone Ext:

eMail:

Bank Information:

 Primary Business Account Bank Name:

Address:

City:

State:

Zip:

 Fax:

eMail if any:

Account #:

Contact Name:

Phone:

Trade References:

 Trade Reference 1:

Contact:

Address:

City:

State:

Zip:

 Phone:

Fax:

eMail:

Notes:

 Trade Reference 2:

Contact:

Address:

City:

State

Zip:

 Phone:

Fax:

eMail:

Notes:

PURCHASE AGREEMENT: Buyer understands that all discounts and freight allowances are only deductible from invoice if payment is postmarked within 30 days of invoice date. Buyer agrees to pay thePoint (dba; BODY PARTS) according to invoice terms. I/we understand that failure to pay within 30 days will result in addition of 1.5% per month to the unpaid balance in addition to full list price being charged. I/we also agree to pay any and all necessary expenses of collection and attorney fees (typically 50% or more of the total amounts due), which shall be added to the invoice(s) in question. If Blanket Purchase Orders are submitted, undersigned agrees to terms of that contract as described. Undersigned agrees to be responsible for amounts contracted for the company specified by the authorized individuals above, has read and understood the above.

Name:

Signature (Required on printed form only):

_________________________________________________

Original, signed hard copy to be sent via Postal Service if submitted by eMail.

Position or Title: