Credit Application Request

CUSTOMER INFORMATION

DESCRIPTION OF BUSINESS

LICENSING INFORMATION

BANK REFERENCE

TRADE REFERENCES (Open Accounts Only)




COMPANY PRINCIPALS RESPONSIBLE FOR BUSINESS TRANSACTIONS


PERSONS AUTHORIZED TO PURCHASE



THE UNDERSIGNED AGREES TO THE FOREGOING AND REPRESENTS THAT THE INFORMATION GIVEN IS TRUE, COMPLETE AND CORRECT AND AGREES TO ALL TERMS AND CONDITIONS OF THIS AGREEMENT. The undersigned authorizes Select Equipment Sales, Inc., and its assigns & successors, to obtain any credit information for the purposes of establishing, extending, and maintaining an account with Select Equipment Sales, Inc., its assigns & successors. In consideration of Select Equipment Sales extending credit to the above named customer's account and all indebtedness thereunder and the full, prompt and faithful performance by buyer of all terms, covenants and conditions of the agreement, the undersigned hereby waives any notices regarding this guarantee.

IF THIS APPLICATION IS BEING FAXED. THE FAX COPY IS TO BE CONSIDERED TO BE TO BE THE ORIGINAL COPY AND ALL TERMS AND CONDITIONS WILL APPLY AS IF THE ORIGINAL WAS RETURNED. (INITIALS) THIS CREDIT APPLICATION MUST BE COMPLETED IN ITS ENTIRETY AND SIGNED AND INITIALED ABOVE. PLEASE ENCLOSE A COPY OF YOUR CURRENT FINANCIAL STATEMENT TO FACILITATE CREDIT APPROVAL.

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