EZ-FLO Eastman | Appliance Intallation Catalog

EZ-FLO INTERNATIONAL, INC.

APPLICATION FOR OPEN CREDIT APPLICATION MUST BE COMPLETED IN FULL

BUSINESS NAME: EMAIL: STREET ADDRESS: P.O. BOX: P.O. BOX ZIP CODE: CITY:

STATE: ZIP CODE: PHONE: FAX: TYPE OF BUSINESS: DATE ESTABLISHED: ❏ CORPORATION Officers (Names & Addresses):

❏ SOLE PROPRIETOR Owner (Name & Address): ❏ PARTNERSHIP Partners (Names & Addresses):

BANK REFERENCES: NAME: ACCOUNT #: ❏ SAVINGS ADDRESS: ❏ CHECKING

CITY: STATE: ZIP CODE:

❏ LOAN

PHONE: FAX: CONTACT:

COMMERCIAL TRADE REFERENCES: Give only names of those you buy from on OPEN ACCOUNT. References will not be considered valid unless FULL NAMES, ADDRESSES, and PHONE NUMBERS are included. NAME ADDRESS CITY STATE ZIP PHONE FAX

Amount of Credit Desired Monthly: $ Resale Permit No.: (REQUIRED) Puchase Order Required: ❏ Yes ❏ No Accepts Back Orders: ❏ Yes ❏ No Authorized Buyer: Accounts Payable Contact: Billing Instructions:

Should you approve this application, I (we) agree to pay for all goods purchased under terms and conditions agreed upon. EZ-FLO International, Inc. is authorized to contact any references or banks listed above. It is understood that any information so obtained will be used solely for granting credit. (Past due accounts may be subject to a service charge. Should it become necessary to collect this account through an attorney, by legal proceedings, or otherwise, the undersigned, including endorsers, promise to pay all cost of collections, including reasonable attorney’s fees.)

Authorized Buyer / Co-Officer / Partner:

Title: Date: Should a credit availability be granted by EZ-FLO International, Inc., all decisions with respect to the extension or continuation shall be in the sole discretion of EZ-FLO International, Inc. EZ-FLO International, Inc. may terminate any credit availability within its sole discretion.

Visit our website at www.ez-flo.net

EZ-FLO International, Inc. 2750 E. Mission Blvd. Ontario, CA 91761

Customer Service: 800.486.5256 Order Fax: 866.827.3012