Credit Application

    Instructions: Please fill out this form (use your TAB button to advance fields) in its entirety and sign below. When complete, please press SUBMIT. You may also fax the application and all supporting documents to +1 (301) 499-9400 or email it to cscott@reagg.com. Incomplete information may result in longer processing times. Thank you for taking the time to complete this form. We appreciate your business!

    PART I-COMPANY INFORMATION

     

     

    BUSINESS LICENSE NUMBERS>>>

     

    PART II - BANK INFORMATION

    PART III - TRADE REFERENCES



    PART IV - CONSENT TO TERMS

    I/WE HEREBY CERTIFY THAT ALL STATEMENTS MADE ARE TRUE AND COMPLETE, ARE SUBMITTED FOR THE PURPOSE OF OBTAINING CREDIT, AND THAT REAGG LLC AND/OR THEIR AFFILIATES MAY RELY ON THEM FOR SUCH DETERMINATION. I/WE AUTHORIZE REAGG LLC AND/OR ITS AFFILIATES TO OBTAIN SUCH INFORMATION AS YOU MAY REQUIRE CONCERNING THE STATEMENTS MADE IN THIS APPLICATION, AND AGREE THAT THE APPLICATION SHALL REMAIN THE PROPERTY OF REAGG LLC REGARDLESS OF CREDIT DECISION. REAGG LLC MAY REQUIRE THE PERSONAL GUARANTEE(S) OF THE APPROPRIATE CORPORATE OFFICER(S) OR PRINCIPAL OF THE ENTITY REQUESTING CREDIT, A CREDIT CARD GUARANTEE, A BANK LETTER OF CREDIT, AND/OR AN OPERATING DEPOSIT. REAGG LLC IS AUTHORIZED TO ANSWER QUESTIONS ABOUT THIS CREDIT PROCESS BETWEEN REAGG LLC AND ME/US. I/WE CERTIFY THAT I/WE HAVE THE APPROPRIATE AUTHORITY TO REQUEST CREDIT AND TO ENTER INTO THIS ARRANGEMENT, IF APPROVED. I/WE ALSO UNDERSTAND THAT THERE IS NO OBLIGATION TO PURCHASE PRODUCTS OR SERVICES FROM REAGG LLC AND/OR ITS AFFILIATES, REGARDLESS OF CREDIT DECISION.

    I/WE UNDERSTAND AND AGREE THAT THE TERMS OF CREDIT ARE NET 10 DAYS. IF OUR ACCOUNT REMAINS OUTSTANDING FOR MORE THAN 10 DAYS, I/WE AGREE TO PAY A FINANCE CHARGE OF 2% PER MONTH ON ANY OUTSTANDING BALANCE. IF ALL OR ANY PART OF THIS ACCOUNT SHOULD BECOME OVERDUE AND PLACED IN THE HANDS OF AN ATTORNEY OR OTHER AGENCY FOR COLLECTION, YOU WILL BE REQUIRED TO PAY ATTORNEY AND/OR COLLECTION FEES OF A REASONABLE AMOUNT ALLOWED BY LAW.

    I/WE SIGN THIS AGREEMENT IN GOOD FAITH AND UNDERSTAND THAT SIGNING THIS APPLICATION IS OUR CONSENT TO OBTAIN A CONSUMER CREDIT REPORT AND CONTACT OUR BANK AND TRADE REFERENCES TO EVALUATE OUR CREDIT IN CONNECTION WITH THIS APPLICATION.


     

    SIGNATURE OF APPLICANT *