Full Circle Bodyworks
6730 St Rt 503 North
PO Box 67
Lewisburg, OH 45338

FullCircleBdywks@aol.com
www.FullCircleBodyworks.com

            Ph: 765-993-1513
            Fax: 937-962-4548

Please print, complete, and mail to Full Circle Bodyworks.  Thank you.
Credit Application For Wholesale Customers

Business Information       Please Print

 

Business Name

 

Date Established

Street Address

City, State, ZIP

E-mail Address

Contact person

Phone #

Fax #

Credit Limit Requested: $

 

Type of Business: □Corporation     □Partnership     □Sole Proprietorship    □LLC   □Other

Sales Tax Status: □Exempt   □Non-exempt  (Exempt businesses must provide valid State Tax Exempt Certification to avoid being charged sales tax.)

P.O. Required for order Placement: □Yes    □No

 

Authorized Signatures on P.O.

Accounts Payable contact

Accounts Payable Phone #


Bank Reference
 

Bank Name

Street Address

 

City, State,

                           ZIP

Contact Person

Phone #

Fax #

Account #’s

 


Credit References  - Three Main Vendors

 

Business Name      

Street Address

City, State,

ZIP

Contact Person

Phone #

Fax #

Account #

Business Name      

Street Address

City, State,

ZIP

Contact Person

Phone #

Fax #

Account #

Business Name      

Street Address

City, State,

ZIP

Contact Person

Phone #

Fax #

Account #

Payment Terms: Application cannot be processed unless signed by a principal, owner or authorized accounts payable personnel.   Payment shall be net thirty  (30) days from the date of invoice, unless otherwise agreed in writing by Full Circle Bodyworks.  All amounts past due shall be subject to a finance charge of one and one-half percent (1½ %) per month (18% per annum), or such lesser rate as shall constitute the maximum rate allowable under applicable law.  In addition, customer agrees to pay Full Circle Bodyworks all attorneys’ fees and court costs reasonably incurred in collecting any past due amounts.  All checks not honored by your bank will be subject to a $25.00 returned check fee.

I Authorize the release of any and all Credit / Banking information as required by and to Full Circle Bodyworks.

Applicant (please print)

Signature

Title                                                                                            Date