You can also print out and fax application to us if you prefer. The two lines below must be filled out by owner or officer of the company. By submitting this application, applicant is giving authorization to supply Hayes Instrument Co. with credit information. Submission of this form attests to financial responsibility, ability and willingness to pay our invoices within the terms of sale. Should Hayes Instrument Co. require assistance to collect any outstanding balances, applicant agrees to pay all reasonable attorney and collection agency fees.
Applicant certifies that the above is true and correct.