Page 69 - KNA Supply Pro-Shop Catalog 2024

KNA NEW ACCOUNT FORM
CREDIT APPLICATION
COMPANY INFORMATION
COMPANY NAME:
STREET ADDRESS:
CITY: ____________ STATE:_______________ ZIP CODE: ________________
TELEPHONE NO.: ________________ FAX NO.:______________ EMAIL: ____________________
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
Checking Savings
BANK NAME:
Address:
City: State: Zip Code:
Tel.# Fax#

Account#:
TRADE REFERENCES
(1) NAME:
DBA:
Account#: Contact:
Address:
City: State: Zip Code:

Tel.# Fax#
(2) NAME:
DBA:
Account#: Contact:
Address:
City: State: .Zip Code:
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 the following Credit Cards (VISA, MASTERCARD
and AMERICAN EXPRESS). NET 30 Terms based on approved credit. No Credit Card Payment off statement. 2/15 Early Pay discount. Return Merchandise Authorization (RMA) # is
required for returns. Refused or returned merchandise are subject to 25% Re-Stocking Fee plus freight. KNA Supply’s 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 • [email protected] • www.knasupply.com