Page 134 - KNA Supply Commodities Catalog 2024

KNA NEW ACCOUNT FORM
CREDIT APPLICATION

COMPANY INFORMATION
COMPANY NAME:
STREET ADDRESS:
CITY: STATE: ZIP CODE:
TELEPHONE NO.: FAX NO.: E-MAIL:

TYPE OF BUSINESS: q WHOLESALE q RETAIL q OTHER NO. OF OUTLETS:
EIN NUMBER: RESALE TAX NUMBER: YEARS IN BUSINESS:

BUSINESS IS: q SOLE PROPRIETORSHIP q PARTNERSHIP q CORPORATION

NAME OF PRINCIPALS
NAME TITLE ADDRESS SOCIAL SECURITY No.

COMPLETE GRAY SECTION IF YOU WOULD LIKE PAYMENT TERMS
BANK REFERENCE
BANK NAME: (3) NAME:
Check Saving DBA:
Address: Account#: Contact:

City: State: Zip Code: Address:
Tel.# Fax# City: State: Zip Code:
Tel.# Fax#
TRADE REFERENCES
(1) NAME: (4) NAME:
DBA: DBA:
Account#: Contact: Account#: Contact:
Address: Address:
City: State: Zip Code: City: State: Zip Code:
Tel.# Fax# Tel.# Fax#
(2) NAME: (5) NAME:
DBA: DBA:
Account#: Contact: Account#: Contact:
Address: Address:
City: State: Zip Code: City: State: Zip Code:
Tel.# Fax# Tel.# Fax#
TERMS and CONDITIONS
Minimum Opening Order is $50.00. Minimum Reorder is $50.00, Under Minimum Charge is $5.00, Drop Ship Charge is $5.00. We accept Credit Cards
(VISA, MASTERCARD, AMERICAN EXPRESS or DISCOVER) Discover card will incur a 2% processing fee, NET30 Terms based on approved credit. 2% early pay.
Return Merchandise Authorization (RMA) # is required for returns. Refused or returned merchandise are subject to 20% Re-Stocking Fee plus freight.
Our liability is limited to the value of the product. Price, product offering and terms are subject to change without prior notice.
We certify that above information is true and correct. We authorize KNA Supply and/or those acting on KNA Supply’s behalf to investigate the
references/information provided in this application. We agree to pay all costs including attorney and collection fees should we fail to pay within
credit terms.
SIGNATURE: TITLE: DATE:

KNA Supply • PO Box 771826, Ocala, FL 34477 • TEL: (352) 351-1170 • FAX: (352) 351-2600 • www.knasupply.com