head1.jpg (25552 bytes)

B u s i n e s s   C r e d i t   A p p l i c a t i o n - fax to 973-325-2690

 

                      

 

                                  

 

                      

 

                                                    

 

Date

 

Credit Line Requested

 

Tax Exempt#

 

                 Customer Number (NCI will assign)

 

 

 

Billing Information

 

Full Legal Name -                                                            _    

Business Tel. #                    _    _        

Fax #                    _      __

 

Street Address                                                                        _   _  

City                            __     

State             

Zip                  

 

Shipping Address (If Different)                                                __    

City                           _ _     

State             

Zip                  

 

How long have you been in business?                                              

Type of business               __                                     _   _

 

Annual Sales Volume                                               _          

Estimated Yearly Purchases                       _                           _   _

 

Is Merchandise Purchased For Resale?

yes

 

no

 

(If yes please attach exemption certificate)

 

 

Business Credit Application

 

Principal Authorizes Officer                                                                    _            

Title(s)                _                        __               _

 

Contact Person(s)                                                                             _        

Duns Number                _                                      ___

 

Name of Parent Company                                                                                                                           __                      _  __    

 

Street Address                                                                             

City                    _ _            

State        _     

Zip              _ _   

 

 

Bank Reference

 

Bank Name                                                       _     

Contact                                      _   _      

Account#                                __   

 

Bank Address                                                                              

City                           _  __   

State             

Zip               __  _ 

 

Telephone Number                                                                     _   

Fax Number                _                                               _  _     

 

 

Trade Reference

 

1) Name                                                        _                             

Acct.#        _                        

Contact                     __        ___   

 

Addr.                                                                               

City                     _  _      

State   _  

Zip             

Tel.         _    _    __  

 

2) Name                                                    _                                 

Acct.#                _                

Contact     ___              __             

 

Addr.                                                                               

City                  _  _         

State    _  

Zip             

Tel.        _      _   __  

 

3) Name                                                               _                      

Acct.#               _                 

Contact          ___                __      

 

Addr.                                                                               

City                    _  _       

State      _

Zip             

Tel.   _          _  __    

 

 


THE UNDERSIGNED, BY THE EXECUTION OF THIS CREDIT APPLICATION, AGREES THAT IT SHALL PAY FOR ALL OUTSTANDING BALANCES PER TERMS
AS AGREED BETWEEN BOTH PARTIES. IN THE EVENT THIS ACCOUNT IS REFERRED TO ANY ATTORNEY FOR COLLECTION, THE PARTIES AGREE THAT
AN ADDITIONAL TWENTY-FIVE (25%) OF THE OUTSTANDING BALANCE DUE WILL BE PAID AS ATTORNEY'S FEES.

 

 

 

Auth. Signature                                                          

(Print Name)                                                    

Title       ___                     

Date                 

 


 

INDIVIDUAL PERSONAL GUARANTEE

 

 

 

I,   (NAME)_____________________________________ RESIDING AT  (ADDRESS)________________________________________ FOR AND IN CONSIDERATION
OF YOUR EXTENDING  CREDIT AT MY REQUEST TO (COMPANY)______________________________________________________ (HEREINAFTER REFERRED
TO AS THE "COMPANY"), OF WHICH I  AM (TITLE)_____________________________________, HEREBY PERSONALLY GUARANTEE TO YOU THE PAYMENT
AT NATIONAL COMMUNICATIONS INC. IN THE STATE OF NEW JERSEY ANY OBLIGATION OF THE COMPANY AND I HEREBY AGREE TO BIND MYSELF TO
PAY YOU ON DEMAND ANY SUM WHICH MAY BECOME DUE TO YOU BY THE COMPANY WHENEVER THE COMPANY SHALL FAIL TO PAY THE SAME. IT IS
UNDERSTOOD THAT THIS GUARANTEE SHALL BE A CONTINUING AND IRREVOCABLE GUARANTEE AND INDEMNITY FOR SUCH INDEBTEDNESS OF THE
COMPANY. I DO HEREBY WAIVE NOTICE DEFAULT, NON-PAYMENT AND NOTICE HEREOF AND CONSENT TO ANY MODIFICATION OF RENEWAL OF CREDIT
AGREEMENT HEREBY GUARANTEE.

 

 

 

Auth. Signature                                                             

(Print Name)                                                   

Title              ___           

Date