Commercial Credit Information

General Business Information

Business Legal Name *

Business Phone *

Business Address *

Business City *

Business Email *

Business Zip Code *

Business Type *

Business Federal ID Number *

Person Liable For Payment (First Name) *

Person Liable For Payment (Last Name) *

Person Liable For Payment (Phone#) *

Date Business Started *

If Incorporated, In Which State? *

Estimated Monthly Purchases *

Business Tax Exempt? *

Yes (please upload copy of certificate)

Upload Copy Of Tax Certificate

Business Location, Do You *

Do You Work From *

Do You Require Any Of The Following?

List Authorized Purchaser

Principal Owner & Partner Information

For Principal Owner 1

Principal 1 First Name *

Principal 1 Last Name *

Principal 1 Phone *

Principal 1 Email *

Principal 1 Address *

Principal 1 City *

Principal 1 State *

Principal 1 Zip Code *

Principal 1 Social Security # *

For Principal Owner 2 (If Applicable)

Principal 2 First Name

Principal 2 Last Name

Principal 2 Phone

Principal 2 Email

Principal 2 Address

Principal 2 City

Principal 2 State

Principal 2 Zip Code

Principal 2 Social Security #

Credit References

Credit Reference 1 (Full Name) *

Credit Reference 1 (Phone) *

Credit Reference 1 (Address) *

Credit Reference 2 (Full Name) *

Credit Reference 2 (Phone) *

Credit Reference 2 (Address) *

Credit Reference 3 (Full Name) *

Credit Reference 3 (Phone) *

Credit Reference 3 (Address) *

Bank Reference

Bank Reference 1 (Full Name) *

Bank Reference 1 (Phone) *

Bank Reference 1 (Address) *

Please Sign Credit Terms

I verify that, under the pains and penalties of perjury, the above statements are material representations and true and correct and are given for the purpose of obtaining the extension of credit by seller. In the event credit is extended, the undersigned agrees to the following: (1) To pay all purchases pursuant to the terms of seller’s invoices and those contained herein, (2) To pay seller reasonable attorney’s fees, which is agreed to be not less than 25% of any outstanding obligation, and cost incurred by the seller in connection with the enforcement of collection of any obligation of the undersigned to seller, (3) To pay all sums due to seller at its address in Dade County, Florida, such county being agreed upon as the county of venue for any suit brought by either party hereto against the other. I represent and warrant that I have read this application in its entirety, and I am fully aware of the consequences hereof:

Confirm Principal 1 (Full Name) | Credit Terms *

Principal 1 (Signature) | Credit Terms *

Clear

Confirm Principal 2 (Full Name) | Credit Terms

Confirm Principal 2 (Signature) | Credit Terms

Clear

Please Sign Personal Guarantee

In consideration of credit being extended by Stein Paint Company to the above named applicant for merchandise to be purchased whether applicant be an individual or individuals, a proprietorship, a partnership, a corporation, or other entity, the undersigned guarantor or guarantors each herby contract and guarantee to Stein Paint Company the faithful payment, when due, of all accounts of said applicant, for purchase made. The undersigned guarantor or guarantors each hereby expressly waive all notice of acceptance of this guarantee, notice of extension of credit to applicant, presentment, and demand for payment on applicant, protest and notice to undersigned guarantor or guarantors of dishonor or default by applicant or with respect to any security held by Stein Paint Company, extension of time of payment to applicant, acceptance of partial payment or partial compromise, all other notices to which the undersigned guarantor or guarantors might otherwise be entitled and demand for payment under this guarantee. Any revocation of this guarantee shall be writing and delivered to Stein Paint Company.

Confirm Principal 1 (Full Name) | Personal Guarantee *

Principal 1 (Signature Date) | Personal Guarantee *

Principal 1 (Signature) | Personal Guarantee *

Clear

Confirm Principal 2 (Full Name) | Personal Guarantee

Principal 2 (Signature Date) | Personal Guarantee

Principal 2 (Signature) | Personal Guarantee

Clear