Please complete our online credit application below and then press the "submit" button at the bottom of the page. Once we receive your application, processing can take up to five working days. We will keep you informed of where your application is in the process, via the email address used in the credit app below.

Credit Application Form

Enter data below

Billing Information Company
Enter Company Name Address
Enter your billing address City
Enter City State
Enter State Zip
Enter Zip Code

Shipping Information Address
Enter your shipping address City
Enter City State
Enter State Zip
Enter Zip Code

Key Contact Person Name
Enter Full Name Title
Enter Title Phone
Enter Phone Number Fax
Enter Fax Number E-mail
Enter Valid E-mail address

Account Payable Name
Enter Full Name Phone
Enter Phone Number Fax
Enter Fax Number E-mail
Enter Valid E-mail address Type Of Business
Enter Type Of Business Date Established
Enter Date Established DUNS No
Enter DUNS Number Business Entity
Select Business Entity

If Incorporation

Data & State of Incorporation
Enter Data & State Fed. Tax ID No
Enter Fed. Tax ID No

Principal Owners or Officers

1. Name
Enter Full Name Address
Enter Address City/State/Zip
Enter City/State/Zip Position
Enter Position

2. Name
Enter Full Name Address
Enter Address City/State/Zip
Enter City/State/Zip Position
Enter Position

BANK REFERENCES

1. Name
Enter Full Name Account No.
Enter Account No. Type of Account
Enter Type of Account

Address
Enter Address City/State/Zip
Enter City/State/Zip Phone
Enter Phone Number

2. Name
Enter Full Name Account No.
Enter Account No. Type of Account
Enter Type of Account

Address
Enter Address City/State/Zip
Enter City/State/Zip Phone
Enter Phone Number

3. Name
Enter Full Name Account No.
Enter Account No. Type of Account
Enter Type of Account

Address
Enter Address City/State/Zip
Enter City/State/Zip Phone
Enter Phone Number

Trade References

Name
Enter Name Address
Enter Address Contact Person
Enter Contact Person Act No
Enter Act No City/State/Zip
Enter City/State/Zip

Phone
Enter Phone Fax
Enter Fax E-mail
Enter E-mail

Name
Enter Name Address
Enter Address Contact Person
Enter Contact Person Act No
Enter Act No City/State/Zip
Enter City/State/Zip

Phone
Enter Phone Fax
Enter Fax E-mail
Enter E-mail

Name
Enter Name Address
Enter Address Contact Person
Enter Contact Person Act No
Enter Act No City/State/Zip
Enter City/State/Zip

Phone
Enter Phone Fax
Enter Fax E-mail
Enter E-mail

Estimate Monthly Purchase
Your Estimate Monthly Purchase Are these purchases seasonal?
Please Select If so, please identifify slow months:
Enter slow months Credit line requested
Credit line requested How often deos your company issue checks?
Check Issue interval

Financial Information Annual Sales Volume
Annual Sales Volume

Depending on the information supplied above, Wood Chips LLC / Shavings, may require a current financial statement in addition to the application to pomptly process your application. If you with, you may furnish the financial statement at this time.
All financial data provided will be treated with strict confidence.
Thank you for your cooperation.

Credit Application / Approval

The above is submitted to Wood Chips LLC credit department for consideration in establishing a line of credit in the name of applicatn (Buyer). If a credit line is Approved, please be advised that our terms of sale are Net 10 days from our invoice date. Your signature below acknowledges that you have read our terms and conditions statement included with this application.

It is understood that Wood Chips LLC (Seller) reserves the right to suspende further deliveries upon failure of the Buyer to make any paument pursuant to the terms of contract or any other agreement between the parties. If in the judgmen of Seller, Buyer's financial responsibility become impaired, Seller may feruse to deliver except for cash on delivery, or at Seller's option prepayment of the total price, and Seller may demand immediate payment in full for all articles previously delivered. A late charge of one and one half percent (1-1/2%) per month (but not in excess of the lawful maximum) may be imposed on all past due balances, prorated on a daily basis for each day that payment is due.

Applicant autorizes the release of all trade credit and bank references information supplied to Wood Chips LLC / Shavings, for the purpose of making a determination concerning credit privileges and agrees to hold all parties harmless of the release of credit information.

Company Name
Enter Company Name Signature
Signature Title
Title Date
Date