Information about http://www.rwsmithco.com/Documents/Creditapp.pdf

Tags: address city state, address street, confidential credit application, county zip, employee owned company, owner information, partnership, salesperson, shipping, sole owner, street address city,
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Language: english
Created: Tue Sep 27 14:55:44 2005
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                                                             CONFIDENTIAL CREDIT APPLICATION
An Employee Owned Company. Established 1935
Contractor's License No. 457555
www.rwsmithco.com
858.530.1800

Salesperson # ____________


SHIPPING INFORMATION:
                                                                                                                                         Please Fax to 858-536-7743
                                                                                                                          FULL OWNERSHIP ENTITY INFORMATION REQUIRED
                                                                                                                          OWNER INFORMATION:
Trade Name or Style (DBA)
                                                                                                                              Sole Owner                Partnership                     Corporation
_______________________________________________________________________
                                                                                                                          Name
Street Address
                                                                                                                          ________________________________________________________________________
_______________________________________________________________________
                                                                                                                          Street Address
City, State                                    County                         Zip
                                                                                                                          ______________________________________ ___________________ _____________
_______________________________________________________________________
                                                                                                                          City, State                                                    County                         Zip
Phone Number                                        Fax Number
                                                                                                                          _____________________________________________ ___ _______________________
(__ ___ )___________________ __________(__ ___)                         _____________________
                                                                                                                          Phone Number                           Fax Number                             E-Mail Address
Mailing Address, if other than above                                          E-Mail Address
                                                                                                                          (          )                            (          ) ___________________________________
_______________________________________________________________________
                                                                                                                          Federal Tax ID Number                          State Of Incorporation                No. of Years in Business
No. of Years under Present Ownership                   Type of Business
                                                                                                                                                                                                              _________________
_______________________________                        _________________________________
PRINCIPAL OWNERS OR OFFICERS INFORMATION:
1. Name                                                                                                                   2. Name

________________________________________________________________________                                                  __________________________________________________________________________

Title                                                          Social Security Number                                     Title                                                          Social Security Number

________________________________                               _____________________________                              __________________________                                     _______________________________

Home Address                                                                                                              Home Address

________________________________________________________________________                                                  __________________________________________________________________________

City, State                                                                   Zip                                         City, State                                                                   Zip

________________________________________________________________________                                                  __________________________________________________________________________

Home Phone Number                                                                                                         Home Phone Number

(_______)________________________________________________________________                                                 (______)___________________________________________________________________



BANKING:                                                                                                                  Branch Office / City                                                          Phone Number

Bank Name                                                      Checking Account Number
_________________________________________________________________________                                                                                                                               (          )          ____________



TRADE REFERENCES: preferably other major non-perishables suppliers.                                                       (General Contractors - please provide other sub-contractor references)

(Please do not include food or liquor vendors)
1. Name                                                                       Phone Number                                City, State                           Type of Product Purchased                               Account Number

                                                                            _(______)______________                       _____________________________________________________________________________

2. Name                                                                      Phone Number                                 City, State                           Type of Product Purchased                               Account       Number

                                                                           __(______)______________                       _____________________________________________________________________________

3. Name                                                                      Phone Number                                 City, State                           Type of Product Purchased                               Account Number

                                                                             (_______)______________                      ______________________________________________________________________________

4. Name                                                                      Phone Number                                 City State                            Type of Product Purchased                               Account Number

                                                                             (_______)______________                      _______________________________________________________________________________



                                                                                                         TERMS OF AGREEMENT
This agreement shall apply to future credit and any existing debt owed by the undersigned to R.W. Smith & Co. (RWS). RWS is authorized to inquire of our bank and trade references to evaluate and update our credit worthiness. I/We release
and hold RWS harmless from any liability which may result from the disclosure of credit rating information. If this agreement is presented via facsimile, it will be considered the equivalent of an original document. If credit terms are extended in
reliance on the information contained herein, I/we agree to the following: (1) To pay RWS for purchases according to RWS standard terms of net 30 days from invoice date. (2) To pay RWS service charges of 1½% per month on any amounts
not paid according to terms. (3) To pay RWS reasonable attorneys' fees and costs incurred in connection with the enforcement of this agreement. If a lawsuit is commenced, I/we agree such lawsuit may be brought in a court of competent
jurisdiction in San Diego County, California and waive the right to any other jurisdiction or venue.




Signature                                                                     Printed Name                                                                   Title                                                          Date

                                                                                                           PERSONAL GUARANTY
In consideration of the extension of credit by the Seller herein to Buyer herein, the undersigned does jointly and severally personally guaranty to pay and be responsible for payment of all sums, balances and accounts due Seller by Buyer,
including collection charges and/or attorneys' fees. This shall be an unconditional and continuing guaranty and shall continue in force notwithstanding any change in the form of such indebtedness, or renewals or extensions granted by Seller,
without obtaining any consent thereto, and until expressly revoked by written notice from me/us actually received by Seller. Any such revocation shall not in any manner affect my/our liability as to any indebtedness existing prior thereto. I/we
hereby waive notice of the acceptance of this agreement, notice of default or non-payment and waive action required by any statute against the buyer. No delay on Seller's part in exercising any right hereunder, or taking any action to collect or
enforce payment of any obligation hereby guaranteed, either against the Buyer or any other person primarily or secondarily liable with the Buyer, shall operate as a waiver of any such right or in any manner prejudice Seller's rights against me/us.
I/we agree that in the event of any default at any time by said Buyer, Seller shall be entitled to look to me/us immediately for full payment without prior demand or notice. I/we specifically agree to the venue and facsimile provisions set forth
above. This guaranty is personal to the signer. Any notation of corporate capacity is for information only and shall not affect the personal nature of the guaranty. Guarantors hereby subordinate all rights of reimbursement of guarantors from
principal debtor to RWS' rights to recover from principal debtor and guarantors. I, the undersigned, consent to R.W. Smith & Co. obtaining a consumer credit report on me in connection with this application for business credit.



Signed                                                                        Date                                                           Signed                                                                    Date

_________________________________________________                                                                                            __________________________________________________
Printed Name                                                                                                                                 Printed Name
                                                                                                                                                                             CONTINUED OVER
CredApp 12061
                       IF PREFERRED, YOU MAY ATTACH YOUR PERSONAL OR CORPORATE FINANCIAL STATEMENT

                                               PERSONAL FINANCIAL STATEMENT
                   ASSETS                                  AMOUNT                                  LIABILITIES                      AMOUNT
    Cash on Hand                                                                     Accounts Payable
    Cash in Banks (Detail)                                                           Notes Payable Banks


    Accounts Receivable                                                              Installment Contracts & Chattel Mortgages
    Notes Receivable
    Supplies                                                                         Income Tax Payable
    Listed Securities (Itemize Separately)                                           Other Unpaid Taxes & Interest
            TOTAL CURRENT ASSETS                                                     Other Liabilities (Current)
    Unlisted Securities(itemized Separately)
    Real Estate Buildings (itemize)
    Mortgages and Trust Deeds - 1st
    Mortgages and Trust Deeds - 2nd                                                  Mortgages or Liens on Real Estate
    Automobiles                                                                      Loans Payable after One Year
    Due from Relatives                                                               Loans on Life Insurance
    Cash Surrender Value- Life Insurance
    Personal Furniture and Appliances                                                TOTAL LIABILITIES
    Office Equipment and Furnishings
    Other                                                                            NET WORTH


      ANNUAL INCOME                                                              and Annual Expenses (excluding ordinary living expenses)
    Salary                                                                           Real Estate payment(s)
    Salary (wife or husband)                                                         Rent
    Securities Income                                                                Income Taxes
    Rentals                                                                          Insurance Premiums
    Other (describe)                                                                 Property Taxes
1                                                                                    Other (describe - include Installment
2                                                                                           payments other than real estate)
3                                                                                1
4                                                                                2
5                                                                                3
                TOTAL INCOME                                                                TOTAL EXPENDITURES
       LESS - TOTAL EXPENDITURES
              NET CASH INCOME
     (exclusive of ordinary living expenses)


    I hereby reaffirm that the above Financial Statement is correct and true and that I have listed all my obligations and debts.


Date _________________________________________________________ Signature _____________________________________________


                                                                                      Printed Name __________________________________________




                       IF PREFERRED, YOU MAY ATTACH YOUR PERSONAL OR CORPORATE FINANCIAL STATEMENT