Confidential Credit Application


Please complete the Credit Application carefully. Any application not filled out completely will not be considered. Typically, it may take four to six weeks for credit approval depending on the cooperation of your credit references.
Date
NAME AND ADDRESS INFORMATION
Legal Name of Business
Shipping Address
Billing Address
Same As Shipping
First Name
Last Name
E-mail Address
ORGANIZATION INFORMATION
Organization Type
Annual Sales Volume
$
Number of acres in production
Have you ever declared bankruptcy?
Have you ever done business under another name?
Have you ever had credit with us or purchased from us before?
OWNERS, PARTNERS, OFFICERS AND/OR STOCKHOLDERS INFORMATION
Please enter a minimum of one (maximum of two)
Name
Contact Address
Phone Number
E-mail
Position
ACCOUNT INFORMATION
Amount of Credit Desired
$
Account's Payable Contact
Account's Payable Phone Number
Account's Payable Email
TERMS AND CONDITIONS
For questions about terms and conditions please e-mail creditapplication@expressseed.com
The information given here will be relied upon as correct and will be kept in strict confidence by our Credit Department. I (we) authorize you to obtain information from the references listed in this credit application.
CORPORATE GUARANTEE
Please complete and sign the Corporate Guarantee and Individual and Partnership Guarantee below. If you are not a corporation you may skip this section.
I, , certify that I am the of , organized under the laws of the state of . Application is hereby made for an Account with Express Seed Company, I accept the terms and Conditions above. In consideration of the extension of credit granted by Express Seed Company, the corporation guarantees payment of whatever amount shall at any time be owing to Express Seed Company on account of goods hereafter delivered, whether said indebtedness be in the form of notes, bills, or open account. The corporation guarantees payment of all interest and service charges due and all cost collection, including but not limited to, court costs and reasonable attorney fees.
INDIVIDUAL OR PARTNERSHIP GUARANTEE
Signature of Authorized Party is required to process application.
Application is hereby made for an Account with Express Seed Company, I (we) accept the terms and Conditions above. In consideration of the extension of credit granted by Express Seed Company to . I (we) hereby jointly and severally unconditionally guarantee payment of whatever amount shall at any time be owing to Express Seed Company on account of goods hereafter delivered , whether said indebtedness be in the form of notes, bills or open account. The undersigned additionally jointly and severally unconditionally guarantees payment of any interest and service charges due on all cost of collection, including but not limited to, court costs and reasonable attorney fees.
EXPRESS SEED COMPANY CREDIT DEPARTMENT
New customers may skip this section
Customer Number
Sales Person
REQUEST FOR CREDIT INFORMATION
I, , certify that I am the of . I hereby authorize the release of certain credit information requested in writing as listed below to Express Seed Company.
TRADE REFERENCES
Please enter a minumum of three (maximum of four)
Name
Contact Address
Phone Number
E-mail
Fax Number