Credit Application

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1. Highlight the Credit application in this frame, then go to file and print.
2. Fill in the application and fax or mail the application to us, you will find our information at the bottom of the page. Application for Credit

Business Name:
Sole [   ]               Partnership [   ]          Corporation [   ] Date Started:
Corporate Name:
Billing Address:

Ship to Address:

Phone:
Fax:
Accounts Payable Contact Name:

Your Bank Name:
Bank Contact Name:
Bank Branch Address:

Bank Phone:
Business Checking Account Number:

Name and Address of Officers, Partners, or Owners

1.
2.
3.

List Name , Address, Phone, and Fax of three principle suppliers with whom you have maintained credit for at least one year.

1.
2.
3.

I/we agree to the terms of Net 30 days unless otherwise stated. In the event of collection, I/we agree to pay all costs and attorney fees. Any balance over 30 days is subject to a service charge of 1-1/2% per month (18% per annum).

Signature Title Date

For Corporations Only – General Continuing Guarantee

In consideration of the extension of credit for goods or services purchased, I/we the undersigned, do hereby jointly, severally, and personally guarantee the prompt payment of any and all indebtedness of the applicant to Unique Technologies Associates. In case suit or action is instituted to collect any portion of an account owed by any parties to this agreement, I/we promise to pay such additional sums as the court may adjudge reasonable, including attorney’s fees.

Print Name Signature Date

Mail to:

Unique Technologies Associates

42 Mileed Way

Avenel, NJ 07001

Fax

1-732-882-1777

Send mail to uta-usa@att.net with questions or comments about this web site. Copyright © 2005 Unique Technology Associates Last modified: October 04, 2005

Send mail to uta-usa@att.net with questions or comments about this web site.
Copyright © 2005 Unique Technology Associates
Last modified: October 04, 2005