Credit Application

Information

• *Email Address
  *Name of Company
• *Billing Address
  *City
• *State
  *Zip
• *Shipping Address
  *City
• *State
  *Zip
• *Entity Type (e.g. Corporation, Partnership, Sole Proprietorship, LLC)
• *EIN or Social Security #
  *Number of Employees
• *Principal Name & Title
  *Principal Phone Number
• Principal Name & Title
  Principal Phone Number
• *Purchasing Contact Name
  *Contact Phone # and Extension
• *Accounts Payable Contact Name
  *Contact Phone # and Extension
• *Years in Business
  *Are you tax exempt?
• *List Any Trade References
• WORKGEAR.COM, PAYMENT TERMS ARE NET 30 DAYS. SPECIAL ORDER AND/OR USED ITEMS ARE NOT RETURNABLE. PLEASE INFORM OUR OFFICE MANAGER IF YOUR COMPANY HAS ANY SPECIAL PROCEDURES OR REQUIREMENTS FOR BILLS, PURCHASING, OR AUTHORIZED BUYERS. BY SIGNING BELOW YOU ACCEPT THE BILLING AND RETURN POLICIES SET FORTH AND AGREE TO PAY FOR ANY MERCHANDISE. YOU ARE ALSO AGREEING TO PAY ANY ATTORNEY'S FEES, COURT COSTS, COLLECTION FEES AND ANY OTHER EXPENSES INCURRED BY WORKGEAR.COM, TO COLLECT ANY PAST DUE AMOUNTS.
• *Signature
  *Title