Page 486 of Fasteners and Industrial Supplies by MPI Maintenance Products

797 w commercial ave · po box 368 · lowell in 46356-0368 800523-2367 · 219696-6411 · fax 219696-6413 maintenance products inc credit application company name mailing address city ship to address if different city phones purchasing fax owner or president social security or federal id number years in business nature of business state zip code state zip code cut along dotted line shop corporation accounts payable proprietorship partnership title bank name address checking account number if you are tax exempt please attach a signed sales tax exemption certificate credit references we need three current sources of supply with whom you do business with on an open 30 day account please do not use banks credit card companies or secured loans as references name 1 2 3 address phone acct terms of payment are net 30 days past due invoices are subject to a 1-1/2 monthly service charge credit privileges are revoked if consistently past due minimum invoice charge is $10.00 cost of collecting money due and owing on this account including court and attorney fees will be charged to the debtor in making this application the customer agrees to these terms signature title date

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