APPLICANT INFORMATION
Name:	(Full Legal Name of Company, Partnership, Individual or Government Entity)
Address:
City:
State:	Please Select AL AK AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VI VT WA WI WV WY
Zip:
Country:
Mailing Address: (If Different)
Bus. Phone:
Fax:
E-Mail:
Website:

BUSINESS REQUIREMENTS:
Type of Organization:	Proprietorship   Corporation   Partnership   General   LLC   Trust   Government Entity   Other:
Tax ID#:
Length of time in Business:
State of Incorporation:
Type of Business:	(Manufacturer, Builder, General Contractor, Electrician, Remodeling Contractor, Local, City, State or National Government Entity, etc.)
Amount of Credit Requested?:	(Estimated Monthly Purchases)
Terms Requested: Note: Generally your terms of payment are initially dictated by volume. However, special exceptions can be made on a case-by-case basis.	If Expected Monthly Sales Volume from Our Company is Between 0.00 - 199.00 - Net 7 If Expected Monthly Volume is Between 199.00 - 499.99 - Net 15 If Expected Monthly Volume is More Than 499.99 - Net 30 Please Select Net 7 Net 15 Net 30
Previous Business Name & Address:
Accounts Payable Contact:
BILLING REQUIREMENTS:
P.O. Required:	Yes  NO
Do you want to apply for a tax-exempt account?	Yes  NO (Certificate must accompany application)
Authorized Purchasers:

INFORMATION ABOUT PRINCIPALS: - Proprietors, Partners, Officers
1.	Name/Title:
	Home Address:
	DOB:
	SS#.:
	Phone.:
2.	Name/Title:
	Home Address:
	DOB:
	SS#.:
	Phone.:
CREDIT INFORMATION: Commercial Trade References
1.	Name of Supplier:
	City/State:
	Phone:
	Fax:
2.	Name of Supplier:
	City/State:
	Phone:
	Fax:
3.	Name of Supplier:
	City/State:
	Phone:
	Fax:
4.	Name of Supplier:
	City/State:
	Phone:
	Fax:

OUR TERMS:

For and in consideration of the extension of credit by SELLER, Angelo's Office Furniture & Supplies, I (BUYER) agree to the following terms: Paragraph 1.) To pay all invoices in full within (20) twenty days of receipt of goods. Paragraph 2.) In the event of the breach of terms as listed in Paragraph (1), I (BUYER) agree to pay a monthly 2% finance charge (APR thus being 24%) on all unpaid past due balances, to be accrued beginning the 21st day after receipt of goods. Paragraph 3.) In the event of default, I (BUYER) agree to pay all costs and expenses of collection, including attorney's fees & finance charges until full payment is made. Note: For charges related to goods purchased for personal/household use, the costs of collection are limited under the Colorado Uniform Consumer Credit Code. Paragraph 4.) I (BUYER) authorize the seller to perform a credit history check and/or contact any of the trade reference(s) stated above; said references being authorized to the release of any relevant information necessary to establish the credit worthiness of the BUYER. Paragraph 5.) I (BUYER) understand Angelo's Office Furniture & Supplies reserves the right to close such account should BUYER breach any of the above contract terms. Date: Signature: (Must be signed by officer(s) of Corp.) Title:

As mentioned earlier, we normally process credit applications within 10 business days. We will notify you once we have determined the status of your account.

Thanks!