Credit Application

Apply for commercial credit and Net 30 payment terms. Complete the application below and our accounting team will review your request.

Commercial Credit Application

Please complete all fields to apply for Net 30 payment terms.

1. Business Information

Legal Company Name *

DBA (if applicable)

Physical Address *

City, State, ZIP *

Billing Address (if different)

Main Phone *

Website

Federal Tax ID (EIN) *

Years in Business *

Business Type *

CorporationLLCPartnershipSole Proprietor

2. Company Contacts

Accounts Payable Contact

Name *

Phone *

Email *

Purchasing Contact

Name *

Phone *

Email *

3. Principal Owner / Officer

Name *

Title *

Home Address (if Sole Proprietor)

4. Bank Reference

Bank Name *

Account Number *

Contact Person

Phone *

5. Trade References (Please provide 3)

Reference 1 *

Company Name

Contact Name

Phone

Account # (optional)

Reference 2 *

Company Name

Contact Name

Phone

Account # (optional)

Reference 3 *

Company Name

Contact Name

Phone

Account # (optional)

6. Credit Request

Requested Credit Line Amount ($) *

Anticipated Monthly Purchases ($)

7. Purchase & Shipping Details

Are Purchase Orders Required? *

YesNo

Preferred Shipping Method / Carrier Account (if applicable)

8. Sales Tax Exemption

Is your company tax exempt? *

YesNo

* If Yes, please email a copy of your Tax Exemption Certificate to shopnboxjames@gmail.com along with submitting this application.

9. Applicant Acknowledgments

By submitting this application, the undersigned acknowledges and agrees to the following:

All invoices are due and payable within thirty (30) days from the date of invoice (Net 30), unless otherwise stated in writing by Shop-N-Box.
A service charge of 1.5% per month (18% per annum) may be applied to all past due balances.
The applicant authorizes Shop-N-Box to contact the bank and trade references listed above to verify credit history.
In the event of default, the applicant agrees to pay all reasonable collection costs, including attorney's fees.

I have read, understand, and agree to the terms and conditions stated above. *

10. Authorized Signature

Digital Signature (Type Full Name) *

Date *

Title *

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