| Optical Resources Credit Application –
Page 1 |
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| Company Information | Principal Owner/Officer Information |
| Company Name
______________________________________ Address ____________________________________________ City ______________________State______ Zip____________ Phone # ____________________________________________ Fax # ______________________________________________ Length Of Time In Business ____________________________ Annual Sales Volume: $ ________________________________ |
Owner/Officer
____________________________________________ Address _________________________________________________ City ______________________State______ Zip____________ Home # ___________________________________________ Social Security # ____________________________________ Driver’s License #___________________________________ |
Bank Information: ( Required for all applicants ) Contact Person _______________________________________ Bank Name __________________________________________ Address _____________________________________________ City ________________State _____Zip ________________ Branch ______________________________________________ |
Phone # __________________________________________ Checking Account # _________________________________ Savings Account # __________________________________ Loan Account # ____________________________________ |
Contact Person _______________________________________ Bank Name __________________________________________ Address _____________________________________________ City ________________State _____Zip ________________ Branch ______________________________________________ |
Phone # __________________________________________ Checking Account # _________________________________ Savings Account # __________________________________ Loan Account # ____________________________________ |
Trade References ( Required if requesting net terms. ) Name _______________________________________________ Address _____________________________________________ City _______________________State ______Zip _______________ Name _______________________________________________ Address _____________________________________________ City _______________________State ______Zip _______________ Name _______________________________________________ Address _____________________________________________ City _______________________State ______Zip _______________ |
Phone ______________________ Fax _____________________ Account # ____________________________________________ Contact ______________________________________________ Phone ______________________ Fax _____________________ Account # ____________________________________________ Contact ______________________________________________ Phone ______________________ Fax _____________________ Account # ____________________________________________ Contact ______________________________________________ |
Optical Resources Credit Application - Page 2
TAX RESALE CERTIFICATE
A separate resale certificate must be submitted for every state in which there are one or more receiving locations.
FIRM NAME ___________________________________________________ BUYER __________________________________________
I HEREBY CERTIFY, That I hold valid seller's permit No. ________________________________ State of ___________________________., issued pursuant to the Sales and Use Tax Law; that I am engaged in the business of selling; that the tangible personal property described herein which I shall purchase from Optical Resources, Inc. will be resold by me in the form of tangible personal property; PROVIDED, however, that in the event any of such property is used for any purpose other than retention, demonstration, or display while holding it for sale in the regular course of business, it is understood that I am required by the Sales and Use Tax Law to report and pay for the tax, measured by the purchase price of such property. Description of property to be purchased: Computer Data Equipment
Signature _________________________________________________ Title _________________________________ Date ___________________
TERMS AND CONDITIONS OF AGREEMENT
This Credit Application and Agreement is submitted by Customer to Optical Resources, Inc. (hereinafter referred to as Optical Resources), to obtain trade credit. Customer agrees to make payment in full to Optical Resources for all amounts due according to Optical Resources' invoice(s). Customer also agrees to pay to Optical Resources, as interest, an amount equal to 1 1/2% per month, or the maximum provided by law (whichever is less) for invoice amounts that are past due. Should customer default in any such payment(s), Optical Resources shall have the right, without notice to Customer, to declare all invoice amounts due and payable. In the event Optical Resources should commence any action or actions, or otherwise seek to enforce this agreement against Customer or any guarantor, Customer agrees to pay reasonable attorneys fees, court costs, and other expenses incurred by Optical Resources, whether or not suit is filed. This agreement is personal to the parties and is not transferable or assignable without prior written consent of Optical Resources. Customer agrees that any change in liability for any debts incurred by Customer to Optical Resources due to change in Customer's form of business, shall not be effective as to Optical Resources until optical Resources receives actual notice of the change by certified mail. Customer's current year end financial statement (balance sheet and income statement) must accompany this application. If it is unaudited, the respective owner/officer must sign and date each financial statement. This agreement shall become effective when optical Resources' written acceptance is received by Customer. This Agreement is entered into, and shall be governed by and construed in accordance with the laws of the State of California. By execution hereof, Customer agrees to be subject to the jurisdiction of the courts of the State of California.
By signing this agreement, I hereby authorize the release of credit and banking information to optical Resources, Inc., by any bank or references listed.
Signature ___________________________________________________ Title ________________________________ Date _________________
Signature ___________________________________________________ Title ________________________________ Date _________________
PERSONAL GUARANTY
I (we), the undersigned, for and in consideration of Optical Resources, Inc. extending credit at my (our) request to ______________________________ ____________________________________________ (hereinafter referred to as the Company), hereby (jointly and severally) agree to personally guarantee payment of all amounts due and owing Optical Resources, Inc. by the Company, plus any and all interest due and owing, and all other expenses incurred by Optical Resources, Inc. including attorneys fees, as set forth in the foregoing application for credit. It is understood that this guaranty shall be a continuing and irrevocable guaranty and indemnity, for such indebtedness of the Company. This guaranty shall be governed by and construed in accordance with the laws of the State of California. By execution hereof, the Guarantor agrees to be subject to the jurisdiction of the courts of the State of California.Signature ___________________________________________ Print Name ____________________________________ Date _______________