Credit Application

Company Name

Name of Applicant

First Name

Last Name

Phone Number

Email Address

Name of Owner / President / CEO

First Name

Last Name

Phone Number

Email Address

Name of Accounts Payable Contact

First Name

Last Name

Phone Number

Email Address

Name of Purchaser Contact

First Name

Last Name

Phone Number

Email Address

Shipping Address (Street, City, State, ZIP)

Billing Address (Street, City, State, ZIP)

Name of STAUF Representative

Line of Business

Years in Business

DUNS Number

Annual Sales

Credit Requested

Have you ever been subject to Bankruptcy Chapter 7, 11 or 13?

Yes

Federal Tax ID

Reference #1

Phone

Reference #2

Phone

PARTIES HEREBY AGREE THAT ALL PURCHASES MADE ARE SUBJECT TO THE FOLLOWING TERMS AND CONDITIONS:

I certify the information above is correct and authorize references to release any account information requested.

agree2

The undersigned purchaser hereby agrees that all amounts due for goods and/or services purchased from STAUF USA, LLC are payable to STAUF USA, LLC.

agree3

The undersigned agrees to pay, in the event the account becomes delinquent and is turned over to an attorney for collection, reasonable attorney's fees, plus all attendant collection costs, plus reasonable interest, and agrees any action or proceeding to enforce any provision of, or based on any right arising out of, this Agreement may be brought against any of the parties in the courts of the State of Tennessee, County of Shelby, or it has or can acquire jurisdiction, in the United States District Court for the Western District of Tennessee, and each of the parties consents to the jurisdiction of such courts (and of the appropriate appellate courts) in any such action or proceeding and waives any objection to venue laid therein. Process in any action or proceeding referred to in the preceding sentence may be served on any party anywhere in the world.

agree4

The parties hereby agree that the goods and/or services purchased from STAUF USA, LLC are not payable in installments, but are payable per invoice terms.

agree5

The signature below indicates permission to obtain credit information from any source or persons.

Name and Title

Date

Your Signature

INDIVIDUAL PERSONAL GUARANTEE:

In consideration of STAUF USA, LLC extending credit, the undersigned does hereby individually, jointly, and severally to pay for all goods and/or services supplied to any of us and/or the above named business. In the event it becomes necessary to place the account with an attorney and/or collection agency for collection, we agree to pay all costs of collection including reasonable attorney's fees, plus all attendant collection cost, plus reasonable interest and hereby waive our privilege of being sued in the county of our residence and agree that if a suit is brought, that venue will be in Shelby County, Tennessee at the Option of STAUF USA, LLC. The undersigned agrees any action or proceeding to enforce any provision of, or based on any right arising out of, this Agreement may be brought against any of the parties in the courts of the State of Tennessee, County of Shelby, or it has or can acquire jurisdiction, in the United States District Court for the Western District of Tennessee, and each of the parties consents to the jurisdiction of such courts (and of the appropriate appellate courts) in any such action or proceeding and waives any objection to venue laid therein. Process in any action or proceeding referred to in the preceding sentence may be served on any party anywhere in the world.

Name and Title

Date

Your Signature

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Credit Application

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