CREDIT APPLICATION AND AGREEMENT
 
 
COMPANY INFORMATION 
COMPANY NAME: 
ADDRESS: 
PO BOX: 
CITY: 
  STATE:    ZIP  :
TELEPHONE: 
FAX: 
 
 
REQUESTED CREDIT: 
YEAR STARTED: 
 
EMAIL ADDRESS: 
 
 
TYPE OF BUSINESS: 
CORPORATION   PARTNERSHIP  SOLE PROPRIETOR 
 
COMPANY CONTACTS
 
OFFICER IN  CHARGE
ACCTS  PAYABLE: 
PURCHASING: 
 
PRINCIPAL
 
NAME: 
POSITION: 
HOME ADDRESS: 
CITY: 
  STATE:    ZIP 
HOME PHONE  # 
SOCIAL SECURITY # 
 
TRADE REFERENCES
 
1. COMPANY: 
CONTACT: 
PHONE: 
FAX:
 
2. COMPANY: 
CONTACT: 
PHONE: 
  FAX:
 
 3. COMPANY: 
 CONTACT: 
PHONE: 
  FAX:
 
BANK REFERENCE
 
BANK: 
ADDRESS: 
PHONE  #: 
  FAX: 
 ACCT #: 
CONTACT:
 
 PERSONAL GUARANTEE OF PAYMENT AND AGREEMENT:
 
 To induce Globe Electric Supply Co., Inc. (“Globe”) to sell and/or continue to sell and deliver goods on credit to the above customer, and in consideration thereof, the undersigned, being financially interested in the above customer, hereby, jointly and severally, unconditionally, guarantee payment when due of all indebtedness of the above customer including any amount currently due to Globe as such indebtedness may exist from time to time together with interest and/or finance charges. This guarantee shall be effective and binding despite any terms or conditions of payment or extensions there of which may be granted by Globe to the above customer, notice of which is waived by the undersigned. Notice of default of payment by the above customer is likewise waived by the undersigned. Should Globe seek to enforce this guarantee, the undersigned, jointly and severally, agree to reimburse Globe for any expenses, of collection, including reasonable counsel fees, costs and disbursements. By typng my name and checking the box marked "ACCEPT", I agree to be legally bound by the terms and conditions as set forth in the statement above. 
  
DIGITAL SIGNATURE 
 
 I accept this agreement    I do not accept  this agreement
NAME:
  (Digital Signature)