Layout 1 (Page 1)

All fields must be completely filled-out in order to avoid any delay in processing of your application

Credit Application LEGAL NAME: Bill To Address: Ship To Address: Years In Business:

A Division of Young Systems Corporation

DBA Name:

City:

State:

Zip Code:

City: Type Of Ownership:

State:

Zip Code:

Federal ID #: Corporation E-MAIL:

Partnership

Indivdual

TEL:

FAX:

D&B D-U-N-S #: NAME OF PRINCIPLE OFFICERS OR OWNERS

Resale Certificate #:

Name: Name:

Social Security #: Social Security #:

Title: Title:

BANK REFERENCE: Bank Name: Address: Loan Officer: Bank Credit Line: Personal Guarantee A/P Contact Name: TRADE REFERENCES: Sales Contact Name:

Cell Phone #: Cell Phone #:

email: email:

Account #:

Zip Code:

State:

Phone #: Secured

No

Yes

No

Yes

Account #: Phone #: State: Credit Line: Account #: Phone #: State: Credit Line: Account #: Phone #: State: Credit Line:

NAME: Address: City: Annual Purchases: NAME: Address: City: Annual Purchases: NAME: City: Annual Purchases: Address:

Contact Name: Fax #:

Zip Code: Terms:

Contact Name: Fax #:

Zip Code: Terms:

Contact Name: Fax #:

Zip Code: Terms:

Estimated Monthly Purchase Amount (for purpose of establishing credit): $

GUARANTEE: The undersigned, jointly and severally guarantees the payment of all debts incurred by the firm listed in this application and accept full resposibilty for all debts.The undersigned waives notice of acceptance of this Guaranty or any extensions in time of payment, and of all other notices to which the undersigned would be otherwise entitled by law and agree to pay all amounts owing hereunder upon demand, without requiring prior action or proceeding against Customer. The undersigned further agrees to keep within your terms if granted open account. Should this account ever become delinquent and it be necessary to employ an attorney to collect or commence suit to enforce payment, the undersigned agrees to pay a reasonable attorney fees and the cost of such suit. A late charge of 1 1/2% per month will be charged on all past due amounts. The information in this application and all financial statements submitted in connection herewith is for the purpose of obtaining credit and is represented by the applicant to be true and complete. The applicant authorizes Nuworld to investigate all credit references and any other matter pertaining to its financial responsibility, and acknowledges receipt and acceptance of the terms and conditions attached herewith. Do we have your permission to fax or email promotions, updates and pricing to you: Date: Signed By: Name & Title: Yes No THIS MUST BE SIGNED BY OWNER/OFFICER

Social Security #: Guarantee Date:

Principle Signature: Co-Principle Signature:

Name:

:emaN

:# ytiruceS laicoS

Internal Use Only Payment Terms:

Signed:

Date:

Credit Line:

13125 Midway Place, Cerritos, CA 90703 • Tel: 562-921-2256 • Fax: 562-921-4055 • email: info@nuworldinc.com • website: www.nuworldinc.com

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