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    Please use the form below to submit your application for commercial credit. (* = Required field)

     

    428 HUDSON RIVER ROAD WATERFORD, NY 12188 (518)235-3645 FAX (518)235-0778

  • BUSINESS INFORMATION

  • BANK INFORMATION

  • CONTACT INFORMATION

  • BUSINESS/TRADE REFERENCE #1

  • BUSINESS/TRADE REFERENCE #2

  • BUSINESS/TRADE REFERENCE #3

  • AGREEMENT

  • If my application for credit is accepted it is agreed that such credit is being extended on the following terms:

    1. I will be permitted, from time to time, to purchase goods and services on credit, all chargeable to my account. I agree to pay for such purchases within my assigned terms.

    2. If I do not pay within the credit terms granted, you may immediately suspend my rights to credit and cease shipment of goods to me. If I do not pay and you must send this account to collection, I agree to pay all costs of collection, including but not limited to your attorney’s fees.

    3. I hereby authorize the company to whom this application is made or any credit bureau or other investigative agency employed by such person to investigate the references herein listed or statements or other data obtained from any other person pertaining to my credit and financial responsibility or my business or personal obligations.

  • SIGNATURE