Sales Rep

Date *

Business Information

Legal Business or Company Name *

Trade Name or DBA, if Any

Federal ID / FEIN Number *

Address 1 *

Address 2 (Optional)

City/Town *

State/Province/Region *

ZIP/Postal Code *

Country *

Business Telephone *

Business Email Address *

Business Fax

Business Website

Select the type of business you have *

How many years has the business been established? *

Principals or Owners

1. Full Name *

Home/Cell Phone *

Business Title *

Social Security Number *

Date of Birth *

Home Address (City, State, Zip) *

Email Address *

2. Full Name

Home/Cell Phone

Business Title

Social Security Number

Date of Birth

Home Address (City, State, Zip)

Email Address

3. Full Name

Home/Cell Phone

Business Title

Social Security Number

Date of Birth

Home Address (City, State, Zip)

Email Address

Bank References

1. Bank Name *

Bank Address (City, State, Zip) *

Account Number *

Routing Number *

2. Bank Name

Bank Address (City, State, Zip)

Account Number

Routing Number

Trade References

1. Business Name *

Phone Number *

Contact Name *

Fax Number

Address (City, State, Zip) *

Email Address *

2. Business Name *

Phone Number *

Contact Name *

Fax Number

Address (City, State, Zip) *

Email Address *

3. Business Name

Phone Number

Contact Name

Fax Number

Address (City, State, Zip)

Email Address

Credit History Consent

I (Business/Trade name of the Customer/Buyer) release the opportunity for Karabetian Import & Distribution, Inc. to access my credit history from my trade vendors and my bank account info to establish an open line of credit with them.

Credit History Authorization *I agreeI (Business/Trade name of the Customer/Buyer) release the opportunity for Karabetian Import & Distribution, Inc. to access my credit history from my trade vendors and my bank account info to establish an open line of credit with them.

Title *

Name *

By submiting this credit application/agreement, the individual executing this Application below on behalf of Buyer, individually and personally, represents and warrants Karabetian Import & Distribution, Inc. that: 1) he/she is authorized to execute this Application on behalf of Buyer; 2) the information set forth in this Application is accurate and complete; 3) any legal action brought by Buyer will be in the jurisdiction of California, and Buyer hereby submits to the jurisdiction of said courts. The laws of the State of California will apply. Additionally, the prevailing party shall be entitled to recover its costs, including attorneys/ fees, collection agency fee, from the other party; 4) Buyer agrees to pay interest on any unpaid purchases, beginning 30 days after the payment due date, at the rate of 1.5% per month; 18% per annum, or the maximum judicial rate, whichever is less. In signing this Application, Buyer agrees to all of the above and hereby grants permission for credit information to be verified by company (ies) and financial institution(s). The undersigned also understands that Karabetian Import & Distribution, Inc. will retain this Application, whether or not it is approved, and that Karabetian Import & Distribution, Inc. will consider this Application as a continuing statement of the undersigned’s financial position and situation until notified otherwise by the Buyer. In order for Karabetian Imports, Inc to sell and to continue to sell to Buyer, Buyer hereby represents and warrants that it is solvent and that it pays its obligations as they become due. The preceding representation and warranty will be deemed to be repeated in each purchase by Buyer. Faxed documents will be deemed as original. No oral agreements will be accepted. The terms on this credit application/agreement overrides all others.

Business/Trade Name of the Customer/Buyer *

Title *

Date *

Personal Guarantee

For good and valuable consideration, the undersigned (jointly & individually) agree to be personally liable for all indebtedness incurred by the above listed corporation or business entity. The undersigned (jointly & individually) further agree to be personally liable for all indebtedness based on the extension of credit to any other corporation or business entity with which the undersigned is or may be affiliated. If a default in the terms of payment occurs on any account on which the undersigned is or may be liable, and which is placed with an attorney or bonded collection agency, the undersigned (jointly & individually) agree to pay an additional 25% collection charge on the entire unpaid balance.

Authorized Signature *

Guarantor Name *

Social Security Number

Date *

Please upload a copy of a Sales Tax exemption #, Federal Tax Id registration or Business License

Upload Document *

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Upload one copy of your sales tax exemption certificate, federal tax ID registration, or business license. Accepted file types: PDF, JPG, JPEG, or PNG. Maximum 10 MB.

Credit Application & Personal Guarantee

Apply for payment terms

Business Information

Principals or Owners

Bank References

Trade References

Credit History Consent

Personal Guarantee

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