HOME ABOUT PRODUCTS LOCATIONS GALLERY RESOURCES EMPLOYMENT CONTACT Request for Account If you would like to set up a credit account with us please download or fill out the form below. Return to: Owen J. Folsom, Inc. P.O. Box 206 Stillwater, ME 04489 Fax: (207) 827-0373 Email: info@ojf-inc.com DOWNLOAD CREDIT APP Credit Application Name of Firm * Billing Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * (###) ### #### Cell Number (###) ### #### Fax (###) ### #### Email Tax Classification * Proprietorship Corporation Partnership Type of Business * PO Number Required * Yes No Age of Business Federal Tax ID Number * Owners/Officers Name * First Name Last Name Title * Name First Name Last Name Title A/P Contact Person * First Name Last Name A/P Contact Phone Number * (###) ### #### Bank Reference Name Address Address 1 Address 2 City State/Province Zip/Postal Code Country Trade References 1. Name of Company * City * State * Phone * (###) ### #### Fax (###) ### #### 2. Name of Company * City * State * Phone * (###) ### #### Fax (###) ### #### 3. Name of Company * City * State * Phone * (###) ### #### Fax (###) ### #### Personal Guarantor I the undersigned, for the above company, hereby personally guarantee payment of any obligation of the above company whenever the company shall fail to pay the sum. It is understood that this guaranty is continuing and irrevocable. I hereby waive notice of default and consent to any modification or renewal of this credit agreement. The undersigned agrees to pay all delinquent amounts processed by an attorney and all fees associated with that process. * First Name Last Name Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * (###) ### #### Date * MM DD YYYY Notice to Applicant Terms of payment on all accounts are net due 30 days from date of invoice. Accounts not paid in full can be assessed a LATE CHARGE of 1.5% per month (18% annual rate). In case of default on payment the purchaser agrees to pay all collection costs, including reasonable attorney's fees. A delinquent account will case credit to be suspended. Do not sign this form until you have read it and the TERMS OF PAYMENT printed above. This statement is submitted to obtain credit and I (we) certify all information is true and complete. I (we) authorize banks, credit bureaus, and other references to release information to Owen J. Folsom, Inc. concerning credit. * First Name Last Name Date * MM DD YYYY Title * Powered by Squarespace.