Credit Application

Company Name_____________________________

Address____________________________________

City____________________________ State_______ Zip____________
Phone __________________ Fax ___________________ E-Mail ___________________

Trade References:

Company Name __________________________

Address _________________________________

City __________________________ State _____________ Zip _________

Phone _________________ Fax ______________________

Company Name __________________________

Address _________________________________

City ___________________________ State _____________ Zip _________

Company Name __________________________

Address _________________________________

City __________________________ State _____________ Zip _________

Phone _________________ Fax ______________________

Bank Information

Bank Name _____________________________

Account No. ____________________________

Phone _____________________ Fax __________________

Contact Person _________________________________

If you are tax exempt, you MUST submit a copy of your tax exempt certificate.

Terms and Conditions of Account Application

Submission of this form is conditioned upon agreement that all statements made are true and correct. Submission authorizes Torbik Safe & Lock to make any and all inquiries necessary for action on this credit application. Company seeking credit by submission of this form hereby indemnifies Torbik Safe & Lock from any liability resulting from their credit survey.

Payment Terms: When credit is extended by Torbik Safe & Lock, payments will be made within 15 days from the date invoiced. Each invoice not paid within 15 days will be subject to a late fee of 1.5% per month until collected. Applicant further agrees to pay any additional costs of collection, including attorneys, agents or other associated expenses incurred by Torbik Safe & Lock in the collection of the delinquent accounts.