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:
A Division of Young Systems Corporation
DBA Name:
City:
State:
Zip Code:
Ship To Address:
City: Type Of Ownership:
State:
Zip Code:
Corporation
Partnership
Indivdual
Years In Business:
TEL:
E-MAIL:
FAX:
Federal ID #:
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: Sales Contact Name:
Cell Phone #: Cell Phone #:
email: email:
Account #:
Zip Code:
State:
Phone #: Secured
No
Yes
No
Yes
TRADE REFERENCES:
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): $
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: Yes No
Name & Title:
Signed By:
Date:
THIS MUST BE SIGNED BY OWNER/OFFICER
GUARANTY: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 or collection agent 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.
Social Security #: Social Security #: Guarantee Date:
Principle Signature: Co-Principle Signature:
Name: Name:
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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