APPLICATION

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Corporation Name*
(d/b/a) Trade Name
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*

Sold To:
Name*
First Last
Attention
Fax
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Business Facts
Corporation Type*
- Proprietorship
- Partnership
- Corporation
- Other
Federal Tax ID #
PACA #
Date Company Started
Date Format: MM slash DD slash YYYY
Length of time at present address

Accounting Information
Accounts Payable Contact*
Number
Email*

Parties hereby agree that all purchases made are subject to the following terms and conditions:
1. The undersigned purchaser hereby agrees that all amounts due for goods and services purchased from the Ingles Produce Inc. are payable at the address shown on the invoice and statement.
2. The undersigned purchaser hereby agrees that all amounts are due to Ingles Produce Inc are payable within 7 days from the date of delivery to the undersigned or as may be otherwise agreed to in writing by the Parties and reflected on Ingles Produce Inc invoices.
3. The undersigned purchaser agrees to pay Ingles Produce Inc a service charge of the greater amount of $20.00 or 5% of the check balance for all protested checks returned by their bank and three times the amount of the face value of the check should suit have to be filed for collection of the same.
4. The undersigned purchaser agrees to pay, in the event that this guarantee is executed by more than one person, then, in such event, the liabilities and obligations of the undersigned shall be joint and several and the relative words herein shall be read as if written in the plural.
5. The undersigned hereby agrees that all payments due Ingles Produce Inc for its goods are not payable in installments, but are payable in full as stated on Ingles Produce Inc invoices are paid; and the undersigned agrees in the event and past due balance, the undersigned shall be liable for and pay as liquidated damages and not as a penalty, all costs of collection, plus an amount due for a reasonable attorney's fee that shall be equal to the sum of 25% of the total amount due Ingles Produce Inc for all sales, plus all interest damages that have accrued and in the event of any appeal, the undersigned shall be liable for the additional award of a reasonable appellate attorney's fee to be decided by the Court and should the undersigned institute an legal proceedings against Ingles Produce Inc and prevail, then it shall be entitled to recover its costs and an award from the Court of reasonable attorney's fees.
By my signature below, I certify that the information contained herein is complete and accurate. This information has been furnished with the undersigning that it is to be used to determine the amount and conditions of the credit to be extended. Furthermore, I hereby authorize the financial institutions listed in this credit application to release to Ingles Produce Inc financial information deemed necessary to arrive at a credit decision.
Officer, Owner, or Partner (Signature)*
Date*
Date Format: MM slash DD slash YYYY
Individual Personal Guarantee
I,
Full Name*
residing at
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
for and in consideration of your extending credit at my request to (Company's Name)
Company Name*
of which I am the
TItle*
Hereby personally guarantee to Ingles Produce Inc payment of any obligation of the company and hereby agree to bind myself to pay on demand any sum which may become due to Ingles Produce Inc by the Company whenever the Company shall fail to pay the same. It is understood that this guarantee shall be a continuing and irrevocable indemnity for such indebtedness of the Company. I do hereby waive notice of default, non-payment and notice thereof and consent is any modification of renewal of the credit agreement hereby guaranteed and is all renewals of extension of credit. The undersigned guarantor agrees to pay in the event the amount becomes delinquent and is turned over to an attorney for collection all attorney's fees plus attendant collection costs.
Officer, Owner, or Partner (signature)*
Witness Signature*
Date*
Date Format: MM slash DD slash YYYY
Phone
This field is for validation purposes and should be left unchanged.

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APPLICATION

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Business Facts

Accounting Information

Individual Personal Guarantee

Contact Info

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