WNL PRODUCTS REQUEST FOR CREDIT

IF YOU WOULD LIKE TO APPLY FOR NET 30 DAY TERMS, PLEASE COMPLETE THIS CREDIT APPLICATION
We will process your application immediately, however, a decision cannot be made until we hear back from your references.

Fields that are marked with an * are required.

COMPANY INFORMATION

Company Legal Name *

DBA

Address *

City *

State *

Zip *

Year Established *

Social Security or Federal Tax ID# *

Company Type *Select OneSelect OneCompany/CorporationPublic SchoolCollege/UniversityGovernmentOther Non Profit OrgOther

Contact Information

Purchasing Contact

Purchasing Contact Name *

Purchasing Contact Phone *

Purchasing Contact Email *

Accounts Payable Contact

Accounts Payable Contact Name *

Accounts Payable Phone *

Accounts Payable Email *

Owner/Officer Contact

Owner/Officer Name *

Officer's Phone *

Officer's Email *

CREDIT REFERENCES (MUST HAVE EMAIL TO CONTACT YOUR REFERENCE)

Company #1

Reference #1 Company Name *

Account Number *

Years Doing Business *

Contact Name, Email & Phone *

First

Last

Company #2

Reference #2 Company Name *

Account Number *

Years Doing Business *

Contact Name, Email & Phone *

First

Last

Company #3

Reference #3 Company Name *

Account Number *

Years Doing Business *

Contact Name, Email & Phone *

First

Last

Terms & Conditions

Terms and Conditions

• For the purpose of establishing this account, I consent to have WNL Products make the usual credit check with each trade reference as well as the bank reference, when applicable. I further agree that upon default in payment, to pay in addition to all outstanding invoices, all collection costs including attorney fees and legal expenses, plus interest at a rate of 1.5% per month (18% per annum) from the date of default on the outstanding invoices.

Digital Signature (by typing my name below I consent to the above agreement) *

Title *

Email *

Date *

PLEASE INCLUDE A COPY OF YOUR RE-SALE OR TAX EXEMPT CERTIFICATE ALONG WITH THIS APPLICATION

Click or drag files to this area to upload. You can upload up to 10 files.

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