CREDIT APPLICATION Application for Credit BUSINESS NAME* BUSINESS ADDRESS* CITY* POSTAL CODE* BUSINESS MAILING ADDRESS (IF DIFFERENT FROM ABOVE) CITY POSTAL CODE PHONE FAX EMAIL* NATURE OF BUSINESS TAX # AMOUNT OF CREDIT REQUIRED* COMPANY TYPE* Choose one. Corporation Partnership Sole Proprietorship DATE ESTABLISHED Principals / Owners NAME* TITLE* DRIVERS LICENSE #* DATE OF BIRTH* NAME TITLE DRIVERS LICENSE # DATE OF BIRTH NAME TITLE DRIVERS LICENSE # DATE OF BIRTH NAME TITLE DRIVERS LICENSE # DATE OF BIRTH References BANK* BRANCH* CONTACT* SUPPLIER* ADDRESS* PHONE* FAX SUPPLIER* ADDRESS* PHONE* FAX I/WE* AND OF* (hereinafter referred to as the corporate customer), apply for credit for the supply of goods, services and materials in accordance with the application for credit concurrently made. I/We being principal(s) of the corporate customer acknowledge that I/we am/are cocustomer(s)/co-purchasers and will be personally responsible jointly and severally with the corporate customer for any and all debts I/we will jointly and severally indemnify you, and see you paid for your account with respect to any order now or hereafter made by the corporate customer. I/We further agree to pay your account within your terms of payment end of the month following purchase, to pay 2% interest and service charges per month (26.82% per annum) on overdue accounts and I/we assure full responsibility for any costs incurred toward collection of account including legal fees. For the purposes of this credit transaction I/We fully consent and authorize yourselves obtaining any personal credit information through any credit bureau, credit reporting agency, government registry, private registry, civil enforcement agency, or Kirwin LLP. I/WE AGREE* APPLICANT INITIALS* IN THE PROVINCE OF Alberta DATED AT November 26th, 2021 Submit Careers Request a Quote Credit Application Terms of Service Privacy Policy 8009 Edgar Industrial Way Red Deer, Alberta T4P 3R3 (403) 346 - 2002 Copyright ©2021 Koch Fuel