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Credit Application & Sales Agreement PDF Print E-mail

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CRYSTAL ELECTRONICS, INC.




APPLICATION FOR CREDIT AND SALES AGREEMENT






SECTION 1: BUYER INFORMATION AND APPLICATION FOR CREDIT (PLEASE COMPLETE FULLY)





Firm Name (“Buyer”)Contact





Telephone NumberFax Number





Billing AddressShipping Address





CityCity





State/Zip + 4 CodeState/Zip + 4 Code



Will purchase be Tax Exempt? ? Yes ? No

If yes, please indicate the basis for tax exemption:

? Tax-Exempt Organization (Please attach evidence of status)

? Purchase for Resale

? Other (Please explain and supply any relevant documentation):





Type of Business: # of Years in Business: # of Employees:



Names and Titles of Principals:

NameTitleSince









Electronic Industry References:

NameCity/State/ZipContactTelephone #Fax #

1.

2.

3.



Bank Reference:

Name: Account #: ? Checking ?Borrowing

Contact: Telephone #: Fax #:

Street: City: State/Zip:



SECTION 2: BUYER CERTIFICATION AND FINANCIAL INFORMATION RELEASE AUTHORIZATION



ALL PURCHASES FROM CRYSTAL ELECTRONICS, INC. ARE SUBJECT TO THIS APPLICATION FOR CREDIT AND SALES AGREEMENT, INCLUDING THE TERMS AND CONDITIONS. THESE TERMS AND CONDITIONS SHALL APPLY (INCLUDING, WITHOUT LIMITATION, SELLER'S LIMITED WARRANTY AND LIMITATION OF LIABILITIES), DESPITE ANY CONFLICTING LANGUAGE CONTAINED IN PURCHASE ORDERS OR OTHER DOCUMENT(S) OR COMMUNICATION(S) EXCHANGED BY THE PARTIES.



THE UNDERSIGNED HEREBY CERTIFIES ON BEHALF OF BUYER THAT THE INFORMATION PROVIDED ABOVE AND ON THE ATTACHED FINANCIAL STATEMENT, IF ANY, IS COMPLETE AND ACCURATE. THE UNDERSIGNED FURTHER AGREES ON BEHALF OF BUYER THAT ALL FUTURE QUOTATIONS AND SALES BETWEEN CRYSTAL ELECTRONICS, INC. AND BUYER ARE SUBJECT TO THE TERMS AND CONDITIONS, AND THAT ANY ATTEMPT BY BUYER TO MODIFY, ALTER, CIRCUMVENT, OR SUPERSEDE THIS APPLICATION OF CREDIT AND SALES AGREEMENT MAY BE DEEMED BY CRYSTAL ELECTRONICS, INC., AT IT’S SOLE OPTION AND ELECTION, TO BE A FAILURE OF CONSIDERATION WHICH SHALL OPERATE TO DISCHARGE CRYSTAL ELECTRONICS, INC. FROM ALL CONTRACT OBLIGATIONS WITH RESPECT TO BUYER.



ON BEHALF OF BUYER, THE UNDERSIGNED AUTHORIZES THE RELEASE TO CRYSTAL ELECTRONICS, INC., OF ANY AND ALL FINANCIAL INFORMATION, INCLUDING BUT NOT LIMITED TO CHECKING AND SAVINGS ACCOUNT INFORMATION, LOAN TERMS AND AMOUNTS, PAYMENT HISTORY AND OTHER INFORMATION DEEMED NECESSARY BY CRYSTAL ELECTRONICS, INC. TO FORMULATE ITS CREDIT DECISION, BY ANY FINANCIAL INSTITUTION OR CREDITOR HAVING SUCH INFORMATION, UPON PRESENTMENT OF A PHOTOCOPY OF THIS AUTHORIZATION. PURCHASER AGREES TO HOLD HARMLESS ANY PARTY RELEASING SUCH INFORMATION TO CRYSTAL ELECTRONICS, INC. FROM ANY LIABILITY RESULTING FROM ACTION TAKEN IN RELIANCE UPON THIS AUTHORIZATION.





Date: ___________________ By: ______________________________________________ Title: _____________________________________
 
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