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TCH WHOLESALE CREDIT APPLICATION
1730 E. Hwy. 50, Ste. 53
Clermont, FL 34711
LOCAL 321-206-8529 TOLL FREE 888-732-9034
FAX 321-251-8061
Business Name___________________________________________Date_____________________
Terms requested: COD Check ___ Net 30 days __ Other _____ Credit Line Requested _________
BILL TO:
Name ___________________________________________________________________________
Address:_________________________________________________________________________
City, State, Zip ____________________________________________________________________
AP Contact Name ______________________ Phone Number ________________________
Email Address _________________________ Fax Number __________________________
FEIN # _______________________________ Sales Tax # __________________________
SHIP TO:
Name ___________________________________________________________________________
Address:_________________________________________________________________________
City, State, Zip ____________________________________________________________________
Buyers Name _________________________ Phone Number ________________________
Email Address ________________________ Fax Number ___________________________
TYPE OF BUSINESS:
Sole Owner __ Partnership __Corporation __ incorporated in the state of _____ in the year of ____.
Corporate Name ________________________________________________________
Officer(s) and/or Owner(s) name, address and title:
______________________________________________________________________
______________________________________________________________________
List all locations covered by this application (each corporation needs a separate application):
______________________________________________________________________
______________________________________________________________________
Statement of Accountability
(must be signed by Owner or Officer)
I/We agree to pay all charges on my account including; all attorney or collection fees incurred by TCH Wholesale in collecting delinquent payments, unpaid checks and 1 1/2 percent monthly finance chargeon all past due bills. If terms are approved I/we understand that all invoices are due from the invoice date.
_________________________________________________________________________
Signature Title Date
TRADE REFERENCES :
1) Business Name_______________________________________________________
_____________________ _______________________________
Phone number Fax number
2) Business Name ______________________________________________________
_____________________ _______________________________
Phone number Fax number
3) Business Name ______________________________________________________
_____________________ _______________________________
Phone number Fax number
4) Business Name ______________________________________________________
_____________________ _____________________________
Phone number Fax number
BANK REFERENCE:
Bank Name _________________________________Branch ____________________
Address ______________________________________________________________
Phone _____________________________Account # __________________________
We authorize all companies and banks furnished as credit references to release the information
requested by TCH Wholesale.
________________________________________________________________________________
Signature Title Date
TELL US ABOUT YOUR BUSINESS:
Check off the classifications which best fit your business:
_____Internet _____Brick & Mortar ____Distributor _____Lingerie _____Adult Book
_____ Adult Novelty _____Gift Basket Other ______________________________
IMPORTANT INFORMATION:
NSF Checks will cause your account to be immediately placed on a
secured funds only status.
There is a $45.00 charge each time a check is returned unpaid.
Please pay promptly. Delinquent accounts could incur a minimum of 25 - 50% fees for collection/legal
agency involvement, in addition to the monthly finance charge already assessed.
THANK YOU FOR DOING BUSINESS WITH US !
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