FOR STORE USE | Salesman Code:
 
 
 
NEW or EXISTING ACCOUNT CREDIT INFORMATION
RETURN TO: P.O. Box 80250 • Billings, Montana 59108 • Phone (406) 245-5107 • Fax (406) 252-1139
SECTION 1
 
 
 
BUSINESS INFORMATION:
 
 
Date:
 
 
 
SELECT YOUR PRIMARY MACON LOCATION:
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
LEGAL BUSINESS NAME or OWNER'S NAME:
 
BILLING ADDRESS
 
 
 
CITY
 
 
 
ST
 
 
 
 
ZIP
 
 
 
 
SHIPPING ADDRESS
 
 
 
CITY
 
 
 
ST
 
 
 
 
ZIP
 
 
 
 
BUSINESS PHONE
 
 
 
BUSINESS FAX
 
 
 
 
OPERATIONAL INFORMATION:
 
YEARS ESTABLISH:
 
 
 
DESIRED CREDIT LINE $
 
 
 
ACCOUNTS PAYABLE CONTACT NAME & PHONE:
 
 
 
 
EMAIL:
 
 
 
Do you require the use of purchase orders?
 
 
 
Tax ID #
 
 
 
Are you tax exempt?
 
 
 
 
Do you required a monthly statement*?
 
 
*Monthly statements are mailed the first week of each month for the previous month's transactions. Invoices are mailed individually.
ACCOUNT TERMS: Please note our terms are 1% @ 10th, net 30 days.
We accept all major credit cards - but no discounts may be taken on credit card transactions. Service charges are assessed on past due accounts at 1.5% and due in that period.
 
SECTION 2
 
 
 
BUSINESS TYPE:
 
 
 
 
 
 
 
 
 
 
 
 
Please list names, titles, home addresses and primary phone for business principles:
 
 
 
 
BANK REFERENCE:
 
BANK NAME:
 
 
 
PHONE:
 
 
 
FAX:
 
 
 
ADDRESS:
 
 
 
CITY, STATE, ZIP:
 
 
 
Have you had loans with this bank?
 
 
 
CURRENT LOAN OFFICER:
 
 
 
BUSINESS/TRADE REFERENCES:
Business references will be contacted to verify their trade history with your company. All information remains confidential. Please provide three references who have offered you a similar line of credit opportunity as MaCon Supply, Inc.
 
 
NAME:
 
 
 
PHONE:
 
 
 
FAX:
 
 
 
CITY, STATE:
 
 
 
 
 
NAME:
 
 
 
PHONE:
 
 
 
FAX:
 
 
 
CITY, STATE:
 
 
 
 
NAME:
 
 
 
PHONE:
 
 
 
FAX:
 
 
 
CITY, STATE:
 
 
 
SECTION 3
 
 
 
PERSONAL GUARANTEE
 
The undersigned hereby guarantees any indebtedness incurred on the aforesaid account (including interest and all collection costs including attorney fees) and waives presentment and demand for payment, notice of non-payment, protest and notice of protest, and consents without notice of any extensions of time or increase in the amount of credit given. The undersigned hereby waives all right to a jury trial and to file a counter-claim and consents to jurisdiction and venue with the Yellowstone County Circuit Court of Montana. This is intended to be a continuing guarantee and shall continue as to all new indebtedness incurred unless and until written notice is served upon MaCon Supply, Inc. by certified mail-return receipt requested; declaring said personal guarantee shall not apply to future purchases. Future updates to this application by completion of a new credit application shall not discontinue this guarantee. A facsimile copy of this agreement shall be as binding as an original.
 
PRINT NAME
 
 
 
TITLE
 
 
 
 
SIGNATURE/DATE
 
 
 
PRINT NAME
 
 
 
TITLE
 
 
 
 
SIGNATURE/DATE
 
 
 
CREDIT HISTORY AUTHORIZATION - Permission to Review credit history
 
I/we authorize MaCon Supply, Inc. to investigate our credit history, bank references and any other information deemed necessary to extend credit on an ongoing basis. I/we agree to immediately notify MaCon Supply, Inc. of any changes in ownership, address, phone number, or form of business. This agreement shall remain in force until written notice of revocation is received by MaCon Supply, Inc. This agreement covers any purchases which the customer makes from MaCon Supply, Inc. which the customer does not pay cash for immediately. Customer will be agreeing to the provisions contained in this agreement each time the customer uses the account or authorizes use thereof. Accounts are due and payable 1% 10th, net 30 days, and all charges are due in full with no option to pay in installments. Late charges will be assessed on past due accounts at 1 ½% per month (18% per annum). In the event the customer fails to pay in accordance with this agreement and collection is made by suit or otherwise, the customer agrees to pay all collection costs, including a reasonable attorney's fee with or without suit. I/we have read and agree to all the terms and conditions of this agreement set forth in this application:
 
PRINT NAME
 
 
 
TITLE
 
 
 
 
SIGNATURE/DATE
 
 
 
PRINT NAME
 
 
 
TITLE
 
 
 
 
SIGNATURE/DATE