Customer Credit Application

The undersigned hereby applies to an open credit account with KD & Company Recycling Inc.

The following is for the exclusive use of KD Landscape Supply & Recycling Inc. and will be kept confidential.

Please email or fax this application to FAX: 763-478-2329 or email: KDLandscaping@gmail.com.

CUSTOMER CREDIT APPLICATION

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GENERAL INFORMATION

Date:

Email:

Firm Name:

DBA:

Phone:

Fax:

Cell:

Billing Address:

City:

State:

Zip Code:

Street Address:

Form of Entity (Check One):

Sole Propiertorship

Corporation

Partnership

Date Entity Formed:

Website:

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PRINCIPAL OWNER / STOCK HOLDER / PARTNER

Name:

Home Address:

City:

State:

Zip Code:

Phone:

SS#:

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PRINCIPAL OWNER

Name:

Home Address:

City:

State:

Zip Code:

Phone:

SS#:

Vice President:

Secretary:

Accounts Payable:

Phone:

Federal Tax ID #:

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BANK INFORMATION

Bank Name:

Branch:

Branch Officer:

Phone:

Name of Account:

Checking:

Yes

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TRADE CREDIT REFERENCES

Company Name:

Complete Address:

Phone:

Email:

Company Name:

Complete Address:

Phone:

Email:

Company Name:

Complete Address:

Phone:

Email:

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The undersigned hereby certifies that he/she has completed the application or read the application as completed and that all statements contained in the application are true and correct to the best of his/her knowledge. KD & Company Recycling, Inc is authorized to investigate and check credit standing and history of the above named firm or individual and those having possession of credit records are authorized to deliver to KD & Company Recycling Inc., whether the application is approved or not. The undersigned also understands that KD & Company Recycling Inc., in extending credit, are relaying upon the forgoing application and financial information.

All credit extended in accordance with this application shall be on the basis of repayment of all sums due no later than the 10th of the following month of invoice. All amounts not paid when due shall be subject to a finance charge of 2% per month on the unpaid balance. The undersigned agrees to reimburse KD & Company Recycling Inc., for the cost of collection: including court costs, lien fees & reasonable attorney's fees, whether or not legal action is commenced.

Firm:

Date:

Name:

Title:

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The undersigned hereby personally guarantees payment of the amounts due in accordance with the above account:

Signature:

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Date:

Full Name: