Restek Credit Application

Restek Credit Application
Business Information
Company Name*
Federal Tax ID #
NAICS Code
Business Type*

Sole ProprietorPartnershipLimited Liability CompanyCorporationPublic SectorOther
Billing Phone*
Billing Address*

Street Address

Street Address Line 2

CityState

Zip Code

Agreement
In providing the above credit information, the applicant authorizes Restek to contact all companies given as references and to make other credit inquiries. Restek’s payment terms are Net 30 days. Restek retains the right to charge 1.5% late charge after 30 days. It is understood that no additional deliveries can be made when an account is delinquent. In the event of a default in payment, applicant agrees to be responsible for all cost of collection, including, but not limited to, collection agencies fees, attorney’s fees, and court costs.
Authorized Signer*

First NameLast Name
Date Signed*

MonthDayYear
Applicant's Email*
[email protected]
Signature*

Clear
By completing this application, I affirm that I am authorized to apply for credit on behalf of this business.
Should be Empty:

Business Information