Company Information
Company
Date Established
D/B/A
Federal Tax ID #
Phone #
Fax #
Address
For Past Years
Shipping Address
Former Business Address (if applicable)
State Resale #
Purchasing Contact
Email
Internet Address
Ownership
Ownership
Name Title SS#
Principal:
Principal:
Principal:
Has the company or any of its principals ever filed for bankruptcy?     
If Yes, Explain:

Trade References
Please provide information for businesses with whom you have open accounts
Company Name Phone Number Fax Number
1)
2)
3)


The undersigned warrants that the information submitted is true and correct and represents that he/she has the authority to execute this credit agreement on behalf of the business identified. G.A. Murdock, Inc. is hereby authorized to investigate the credit references and principals listed above. In consideration for the extension of credit, said business promises to pay for all purchases within the terms agreed (Net 30 Days) and agrees to pay a service charge of 1.5% per month (18% annual percentage rate) on all past due balances. In the event any third parties are employed to collect any outstanding monies owed by said business the undersigned agrees to pay in addition to all sums due, reasonable collection costs, including attorney fees, whether or not litigation has commenced, and all costs of litigation incurred.

The undersigned individual hereby personally guarantees unconditionally and irrevocably the prompt payment of any sums now or hereafter owed to G.A. Murdock, Inc. by the business identified above. This guaranty covers all credit extended, including that in excess of the maximum credit limit, and shall continue in force until notice in writing is received by G.A. Murdock, Inc. Such termination shall in no way release the undersigned as to any sum or debt incurred prior to such termination.

Name of person guaranteeing payment
Date
Home Address
Home Phone
SS#
Name of business whose account is guaranteed
BY CLICKING THE "I ACCEPT" BUTTON YOU ARE AGREEING TO BE LEGALLY BOUND BY THIS AGREEMENT. CLICKING ON THE "I ACCEPT" BUTTON IS AN ELECTRONIC SIGNATURE AND A CONFIRMATION BY YOU OF YOUR AUTHORIZATION TO AGREE TO THESE TERMS.