Business Application - Biloxi, MS Wholesale

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Business Application

Company Name

Phone

Fax

Email Address

Company Physical Address

Address Line 1

City

State

Zip Code

Company Billing Address

Address Line 1

City

State

Zip Code

Business Classification

Incorporated

Partnership

Sole Proprietor

Doing Business As

Other Type

Federal Tax ID #

Tobacco Permit #

Sales Tax #

How long has this company been in existence under current name?

How long have you been in you current location?

Accounts Payable

AP Contact Person

AP Phone

AP Fax

Landlord

Landlord Name

Landlord Phone

Owners, Principals, Officers

Owners, Principals, Officers #1

Name

Title

Address Line 1

City

State

Zip Code

Phone

DL #

DL State

DL Expiration Date

Owners, Principals, Officers #2

Name

Title

Address Line 1

City

State

Zip Code

Phone

DL #

DL State

DL Expiration Date

Trade References

Trade Reference #1

Name

Address

Phone

Contact

Trade Reference #2

Name

Address

Phone

Contact

Trade Reference #3

Name

Address

Phone

Contact

Trade Reference #4

Name

Address

Phone

Contact

Trade Reference #5

Name

Address

Phone

Contact

Bank References

Bank

Address

Phone

Banker Name

Account Type

Account #

I agree that the name below will be the electronic representation of my signature for all purposes just the same as a pen-and-paper signature. I also agree that my IP address and date will be automatically set within this form. By signing this form electronically and clicking "Submit", you are agreeing to the terms and conditions stated herein.

Terms of Agreement

Credit Terms: Credit terms are 7 days from date of invoice. Outstanding balances are subject to 1.5% per month interest in addition to any court costs, attorney fees and cost of collection Corso Inc. may incur in enforcing the terms of this agreement.
Invoices: Invoices are sent on same day that an order is delivered. Invoices are payable within terms established for the customer at the time of invoice creation. Any invoice still due one day after stated terms is considered past due. No additional credit will be extended to past due accounts unless satisfactory arrangements are made with our credit department.
Collection: Collection efforts shall begin on all outstanding invoices extending beyond payment terms established for your account. If collection efforts of Corso’s have failed to produce payment, an account is then classified as defaulted. Any defaulted receivable shall be referred to a collection agency within a reasonable time after the final collection letter.
Restocking fee: A 3% restocking fee may apply on returns exceeding $500 in instances where Corso’s is not at fault.

Name

Address

Date

Name

Address

Date

Personal Guarantee

In consideration for credit extended, the undersigned contracts and guarantees to the faithful payment, when due, of all accounts of the company seeking credit. The undersigned guarantor expressly waives all notice of acceptance of this guarantee, notice of extension of credit, presentment of demand for payment and any notice of default by the company seeking credit and all other notices the guarantor might be entitled to. Revocation of the guarantee shall be in writing and delivered by certified mail.

The undersigned warrants to Corso Inc., that all information furnished is true, correct and complete in all material aspects and understands payment terms, conditions and policies and agree to abide by them all. The undersigned authorizes Corso Inc. to request credit information from all banks, persons and companies listed on this application and from third party credit bureaus.

Name

Address

Date

Name

Address

Date