Credit Application

Line of Credit

Requested *

USD

I intend to place an order *

General

First Name *

Last Name *

Company Name *

Type of Business *

Your Email *

Title *

Phone Number *

Fax Number

A/P Contact *

SIC *

Officers *

Is Purchase Order Required? *

Date Started *

Billing Instructions

Billing Address

Company Name *

Street Address *

City *

State *

ZIP Code *

Shipping Address

Company Name *

Street Address *

City *

State *

ZIP Code *

Trade References

Name of four (4) commercial establishments with whom you are presently doing business on an open account basis:

References 1

Company Name *

Phone Number *

Street Address *

City *

State *

ZIP Code *

References 2

Company Name *

Phone Number *

Street Address *

City *

State *

ZIP Code *

References 3

Company Name *

Phone Number *

Street Address *

City *

State *

ZIP Code *

References 4

Company Name *

Phone Number *

Street Address *

City *

State *

ZIP Code *

Bank Reference

Bank Name *

Phone Number *

Account No. *

Loan Officer *

Street Address *

City *

State *

ZIP Code *

Terms and Conditions

I am furnishing the foregoing information for the purpose of obtaining credit. I authorize you to investigate our record and report to proper persons and bureaus, our performance of this agreement.

In consideration of RK Controls selling merchandise and service to my company on credit and an open account basis; we agree to following terms and conditions regarding all purchases made by us or on our behalf.

1. Terms of payment are net 30 days from date of invoice. If payment for the full amount of all purchases is not made within thirty (30) days of each invoice, a Finance Charge of 1-1/2% per month (annual percentage rate of 18%) or the highest rate allowed by law will be added to the past due balance.
2. In the event that it becomes necessary to place this account in the hands of an attorney and/or collection agency for collection and/or suit; my company agrees to pay not only all such indebtedness, but will also pay any interest on the unpaid principal balance, all cost and expenses incurred by RK Controls in collecting or attempting to collect such indebtedness including, but not limited to, collection agency cost, reasonable attorney's fees (which may be up to 35% of the indebtedness), all court cost, lien or foreclosure expenses, asset search fees, and any and all other costs of collection or enforcement of any judgments. My Company does agree to transpose any legal transactions within the jurisdiction of RK Controls' home office located in Los Angeles, CA.
3. RK Controls reserves the right to place any account on a (COD) Cash on Delivery basis at any time.
4. Return merchandise will be subject to a restocking charge.

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