Business Credit Application - Mid Florida Golf Cars

Business Credit Application (For Commercial Accounts Only)
Please complete the entire application. Fill in all blanks. For questions that do not apply to you, indicate “N/A”. All persons applying for credit must sign this application. This application is intended for business / commercial accounts only.
Note: Incomplete credit application will not be processed.
Upload a Trade Reference Sheet if Available
Tax Exemption Certificate if Applicable
Name / Address
Name*
First Last
Title
Name of Business*
DUNS #
Tax I.D. Number*
Phone*
Email*
Address*
Street Address Address Line 2 City State ZIP Code

Company Information
Type of Business
In Business Since*
Legal Form Under Which Business Operates
- Corporation
- Partnership
- Proprietorship
If Division/Subsidiary, Name of Parent Company
Tax Exempt?*
- Yes
- No
Tax Exemption #
PLEASE ATTACH COPY OF EXEMPTION CERTIFICATE
Current Assets $
Total Assets $
Annual Sales $
Current Liabilities $
Total Liabilities $
After Tax Profit/Loss $
# Employees
Credit Limit Request $

Agreement
I hereby certify that the information contained herein is complete and accurate. This information has been furnished with the understanding that it is to be used to determine the amount and conditions of the credit to be extended. Furthermore, I hereby authorize the financial institutions listed in this credit application to release necessary information to the company for which credit is being applied for in order to verify the information contained herein.
All invoices are to be paid 30 days from the date of the invoice. Monthly late fees – 1.5% compounded.
Date*
Name*
First Last
Title*

Business Credit Application (For Commercial Accounts Only)