Credit Application

Credit App

TERMS: Payment terms are Net 30 from the date of the invoice, unless otherwise specified. Postage is due upon receipt. Balances not paid within terms will accrue a service charge of 2% per month. In the event of default of payment, applicant agrees to pay all collection costs, attorney fees and court costs, plus a 25% collection fee. If your account is past due, orders may be held or placed on COD status at the sole discretion of Universal. A $30 charge will be assessed on all returned checks. All orders are subject to 5% over or under run.

Applicant Name & Title *

Company Name *

Billing Address *

Credit Reference #1 Name & Full Address *

Credit Reference #1 Phone, Fax & Email *

Credit Reference #3 Name & Full Address *

Credit Reference #3 Phone, Fax & Email *

I certify the above information is complete and true. *

I hereby make application for an account on behalf of the above named company in accordance with the terms stated above, and I personally guarantee this account. *

Date *

Phone Number *

Fax Number

Federal ID/SSN *

Business Ownership Type *

Corporation
Partnership
Sole Proprietorship

Credit Reference #2 Name & Full Address *

Credit Reference #2 Phone, Fax & Email *

Bank Reference Name & Full Address *

Bank Reference Phone & Fax *

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