Application for Commercial Credit
Personal Information
Full Legal Business Name:
Business Type:
Corporation
Partnership
Sole Proprietor
Limited Liability Co
Other
If other, please specify:
General description of business:
Approx. annual turnover:
Year established:
State of establishment:
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Washington
West Virgina
Wisconsin
Wyoming
Federal Tax ID Number:
(for sole proprietor, please enter
SSN
and
DOB
)
D.U.N.S Number:
Street Address:
City:
State:
Rhode Island
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Washington
West Virgina
Wisconsin
Wyoming
Zip:
Telephone:
Fax:
Email:
Principal billing Contact:
Names(s) of Authorized Purchasers:
Banking Reference Information
Name of financial institution:
Street Address:
City:
State:
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Washington
West Virgina
Wisconsin
Wyoming
Zip:
Telephone:
Fax:
Your account number:
Account officer at financial institution:
Credit Reference
(use Trade References Only)
(3 References)
Name of Business:
City:
Street Address:
Zip:
State:
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Washington
West Virgina
Wisconsin
Wyoming
Name of Business:
City:
Street Address:
Zip:
State:
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Washington
West Virgina
Wisconsin
Wyoming
Name of Business:
Street Address:
City:
State:
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Washington
West Virgina
Wisconsin
Wyoming
Zip:
Certification and Signature
Business Name:
Name of person signing:
Signature:_________________________________
__________
Title:
Date signed:
Terms and Conditions
Credit terms shall be stated on invoice, but we generally offer a 1% discount for payment within 10 days of invoice. In all cases, net payment is due within 30 days. Purchase order numbers must accompany each sales order. A verbal order will be accepted only when given by an authorized purchaser listed above. No special orders will be accepted without a confirmation of what is to be ordered. All special orders are final. No returns of standard times will be accepted without prior return authorization. A 20% restocking charge will not be refunded. All claims must be made within ten (10) days after receipt of goods. Applicable taxes will be charged unless appropriate exempting documentation is on file prior to shipment. All accounts are subject to review and OSSCO reserves the right to modify or suspend credit at any time. Unpaid balances are liable to interest on the unpaid amount at 18% interest per year. If legal action is instituted by OSSCO to collect debts not paid within 30 days, you agree that all attorney and court fees, interest, reasonable collection costs may be added by OSSCO to your unpaid balance and will become due and payable to OSSCO. OSSCO may modify these terms by sending you by fax, mail, or electronic mail a copy of the amended terms of your attention at the business address above.
Yes, I accept the terms.
No, I do not accept the terms.
Before submission of this application, please print down
and mail in the signed original to:
Attention: Credit applications
OSSCO Bolt & Screw Company
1351 Elmwood Avenue
Cranston, RI 02910
Ossco Bolt & Screw Company
1351 Elmwood Avenue, Cranston, RI 02910
Telphone: 401-461-6900 - Toll Free: 800-367-2688 - Fax: 401-461-6970
Email:
sales@osscobolt.com