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Credit Application

Fill out the form below to apply for a Net 30 account with ProFast Supply. Your application goes straight to our Accounts Receivable team for review.

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Officers / Partners

Name

Title

Name

Title

Trade References (3 minimum)

Name

Account #

Email (preferred)

Phone

Name

Account #

Email (preferred)

Phone

Name

Account #

Email (preferred)

Phone

Banking Reference

Bank

Bank Email

Address

Account #

Phone

Contact

Credit Agreement

I, the undersigned, authorize the release of credit and banking information necessary for the approval of this request.

A late fee of 3% of the outstanding past-due balance, or $1, whichever is greater, will be assessed each month an invoice remains past due. Late fees do not compound. Accounts that remain past due may be placed on hold or closed. Applicant agrees to pay all collection-agency and reasonable attorney fees incurred in collection.

Applicant agrees to the Terms of Net 30 days. I certify the above information is true and correct.

I have read and agree to the terms above. *

Print Name *

Title

Electronic Signature * Typing your name serves as your electronic signature.

Date

Guaranty of Payment (corporations & LLCs)

As further inducement for ProFast Supply Inc. to advance credit to the above named Buyer, I personally guarantee payment to ProFast Supply Inc. of all future indebtedness incurred by Buyer.

Printed Name

Date

Electronic Signature

Questions? Email [email protected] or call 253-301-2200.

Credit Application

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Company Information

Officers / Partners

Trade References (3 minimum)

Banking Reference

Credit Agreement

Guaranty of Payment (corporations & LLCs)