Credit App - SPC Supply

Credit Application

Incomplete and/or unsigned applications will not be accepted for consideration.
* denotes required fields.

*Business Name(Required)

*Date(Required)

*Street & P.O. Box(Required)

*Phone(Required)

Mail Address

Fax

*Owner or Manager's Name(Required)

*Type of Business(Required)

*How many years in present business?(Required)

*Business References (Not Banks) Currently Extending Credit: (References may be presented on your own form.)

Name

Phone

Mail Address

Fax

Account No.

Name

Phone

Mail Address

Fax

Account No.

Name

Phone

Mail Address

Fax

Account No.

I agree to pay all finance charges which may accrue to my account because of non-compliance with the payment terms as stated on Springfield Paper Company's invoice. I understand that finance charges of 1½% per month will be added on all past-due amounts. Should it become necessary to place my account with an attorney for collection, I agree to pay all reasonable attorney's fees and court costs. (Alterations to this statement will void the application, and it will not be considered for open credit).

*Applicant's Signature(Required)

*Title(Required)

If purchases are to be non-taxable, the tax exemption certificate below MUST be completed.

SALES TAX EXEMPTION CERTIFICATE

Issued To
Springfield Paper Company

Address
P.O. Box 3336

City, State, Zip Code
Springfield, MO 65808

Name of Firm (Buyer)

ENGAGED AS A REGISTERED:

Wholesaler

Retailer

Manufacturer

Lessor

Other

Mail Address

The above-named firm is registered with the below-listed state within which your firm would deliver purchases to us, and that any such purchases are for wholesale, resale, ingredients or components of a new product to be resold, leased, or rented in the normal course of our business. We are in the business of wholesaling, retailing, manufacturing, leasing or renting.

Product Or Services Rendered:

Address

State I.D. NUMBER

I further certify that if any property so purchased tax-free is used or consumed by the firm as to make it subject to a Sales or Use Tax, we will pay the tax due direct to the proper taxing authority when state law so provides, or inform the seller for added tax billing. This certificate shall be part of each order which we may hereafter give to you, unless otherwise specified, and shall be valid until cancelled by us in writing or revoked by the state.

General Description Of Products To Be Purchased From Seller As Tax Exempt:

I Swear or affirm that the information on this form is true and correct as to every material matter.

AUTHORIZED SIGNATURE (Owner, Partner, or Corp. Officer)

Title

Date