Bedford Home and Hardware
466 Old Post Road Bedford, New York 10506 BedfordHardware.com
Phone: 914 234-3695 Fax: 914 801-5462 Mail@BedfordHardware.com
CORPORATE CREDIT APPLICATION
CUSTOMER INFORMATION (Please print or type)
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Legal Name of Company dba / Trade Name
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Street Address City State Zip Code
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Mailing Address (if different than above)
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Business Phone Fax
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Person to Contact Phone Fax Email
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Type of Business Business Type (Corporation, Partnership, Etc)
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Federal Tax ID Number Number of Years in Operation
TRADE REFERENCES
Please list companies with which you currently conduct business and which can provide credit references regarding your account
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Company Name City State Phone Fax Account #
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Company Name City State Phone Fax Account #
List below all authorized persons to charge (including applicant):
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________ Initial here if you would like it to be our policy to deny anyone other than those listed above to be able to charge on your account. Statement Balances are due in full by the 10th of each month. There will be a service charge of $25.00 for any check returned by the bank A service charge of 1.5% per month (18% per annum) will be assessed on all past due balances. Any amount past due 30 days or more may, at the option of Bedford Home and Hardware, be referred to an agency or attorney for collection, and the undersigned will be liable for the payment of and all costs and expenses.
Owner or authorized corporate officer must sign:
WE hereby certify that the foregoing statements are true and complete and are made for the purpose of determining the applicant's eligibility for credit. We agree that this statement shall remain your property, whether or not the application is accepted. You are authorized to make all inquiries you deem necessary to verify the accuracy of the statements made herein and to determine the applicants creditworthiness, including, but not limited to, procuring credit information from credit reporting agencies, banks and other financial institutions, references, merchants and others extenders of credit.
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Signature Title Date