Credit Application

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Company
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Street Number
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Street
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City
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  • - select a state -
  • Alabama
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  • West Virginia
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- select a state -
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Zipcode
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Business Phone
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Invalid phonenumber!
Type of Business
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Business Fax
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Invalid phonenumber!
Year Established
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Principal Owner(s) or Officer(s) are:

Your Full Name
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  • - select your title -
  • Mr.
  • Mrs.
- select your title -
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Resident Address
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Resident Phone
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Invalid phonenumber!
Driver's License of Owner
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Banking References:

Bank Name
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Phone
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Invalid phonenumber!
Bank Address
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Account #
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Account Type
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Credit References: (Give only names of those you buy from an open account)

Business Name
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Contact
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Business Address
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Business Phone
Invalid phonenumber!
Invalid phonenumber!
Business Fax
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Business Name
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Contact
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Business Address:
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Your Phonenumber
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Invalid phonenumber!
Business Fax
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Business Name
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Contact
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Business Address
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Your Phonenumber
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Invalid phonenumber!
Business Fax
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EXPRESS TERMS AND CONDITIONS


The information and statements in this application are true, correct, complete and are made for the purpose of inducing STAR to establish an open account line of credit and open book account. STAR is hereby expressly authorized to obtain any information it considers necessary from any source concerning the statements in this application.

In consideration of, and in order to induce STAR to establish an open account based on the foregoing application, the applicant promises to pay for all purchases on the terms as set forth on the invoices. If at any time, for any reason, the applicant is unable to pay for purchases when due, the applicant agrees to pay and authorizes STAR to bill our account for interest computed at the rate of 10% per annum on any past due amount owing on/my account. In the event it becomes necessary to incur collection costs or institute suit to collect any amount due under this agreement or any portion thereof, the applicant promises to pay such additional collection costs, charges and expenses including reasonable attorney's fees.

The undersigned by this Agreement does expressly personally and continually guarantee payment for all services provided to the applicant. The undersigned personally guaranties and assumes joint and several responsibility to STAR along with any company applicant.



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Completed By
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Title
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Date Completed
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