Allen Construction Supply   
 
2827 N. Nichols St
Ft Worth, Tx 76106
(817)624-7095
(817)624-9242 fax
1500 M.L.K. Jr. Blvd
Wichita Falls, Tx 76301
(940)687-2195
(940)687-2698 fax


2827 N. Nichols St
Ft Worth, Tx 76106
(817)624-7095
(817)624-9242 fax
1500 M.L.K. Jr. Blvd
Wichita Falls, Tx 76301
(940)687-2195
(940)687-2698 fax
Credit Application
e. Allen Construction Supply, Inc
2827 N Nichols
Ft Worth, Tx 76106

                                                             APPLICATION FOR CREDIT

Corporate
or Company Name
_____________________________________ Phone____________Fax____________

Street Address________________________________City____________State___Zip_______

Mailing Address_______________________________City____________State___Zip_______

Year Business Started_________

Tax Exempt  __Yes  __No  if yes, enclose your State Sales Tax Exempt Document  
  
_____Proprietorship    _____ Partnership   _____ Corporation _____Other
    
Purchase Orders Required?  ___Yes ___No      Job Number Required? ___Yes ___No


Contact person for credit info________________________  Contact phone number   ____________

Principle's name(s) and position_________________________ DL#_________ SS#___________

Name________________________________ Title____________________ Phone #____________

Home Address_________________________ City_____________________State____ ZIP______

Co-applicant DL#_______________________ SS#________________________

Co-app Name__________________________ Title_____________________Phone #______________

Home Address_________________________  City_____________________State____Zip_________
Please attach company and personal guarantors (if applicable) financial statement to this application 


Credit References:   Bank Name__________________________Bank Officer____________________

City___________________ State___ Phone___________________Fax____________________

Account Number_______________________


Commercial Accounts Only: Suppliers

Name_____________________City________________State___ Phone__________Fax___________

Name_____________________City________________State___ Phone__________Fax___________

Name_____________________City________________State___ Phone__________Fax___________

Name_____________________City________________State___ Phone__________Fax___________

Name_____________________City________________State___ Phone__________Fax___________
             All suppliers must be filled in completely.

                                                                           BUSINESS AGREEMENT

Payment in full for labor and material charges on any open account is due and payable in Tarrant County, 20 days after date of invoice. If any of the billed amount remains unpaid subsequent to that date, the unpaid portion will accrue a late fee charge of 18% per annum (1.5% per month) until paid. All payments received will be applied first to outstanding late charges and then to the amount which has been longest outstanding.

In addition, if it becomes necessary to place an account with an attorney for collection, the undersigned, to the extent permitted by law, shall be liable for all costs and expenses, including attorney fees, incurred by e. Allen Construction Supply Inc. in the collection of the account.

Applicant's signature attests financial responsibility, ability, and willingness to pay our invoices in accordance with our terms.

The above information is for the purpose of obtaining credit and is warranted to be true. I/We hereby authorize e. Allen Construction Supply Inc, to investigate the references listed pertaining to my/our credit and financial responsibility.




_______________________________             __________________________________
Printed Name of Officer                                          Signature of Officer

                                                                                   _______________________
                                                                                   Date


                                                                                                                                                                                                                                     SUBMIT


                                     
Web Hosting Companies