CHARGE ACCOUNTS
Apply for a new charge account. Companies must have a local office in Southern Nevada.
Copy this form, both pages and return it through fax, email or hand deliver (or) request this form via e-mail and we will send you a Word Doc or pdf copy. All applications are subject to approval.
Rec World Inc.
1969 N. Decatur Blvd
Las Vegas, NV 89108
ph: (702) 642-1041 fax: (702) 202-3062
e-mail: recworld@embarqmail.com
Charge Account Application Date________________
Applicant / Company Information
Company Legal Name____________________________________________________________________
Company D.B.A.___________________________________________________________________________
Billing Address_________________________________ City________________ State____ Zip_________
Delivery Address_______________________________ City________________ State____ Zip_________
ph ______________ fax______________ e-mail / accounting ___________________________________
Description of Business___________________________________________________________________
_________________________________ Year established________ Years at present location________
Partnership______ Proprietorship______ Corporation______ Tax ID / EIN #____________________
When Incorporated_____ Where Incorporated_____________________________________________
Resale? Yes_____ No_____ Resale number________________ PO’s required? Yes______ No______
Company Officers
Name___________________________________ Title_______________________ SS#_________________
Address_______________________________________ City__________________ State___ Zip_________
Name___________________________________ Title_______________________ SS#_________________
Address_______________________________________ City__________________ State___ Zip_________
Name____________________________________Title_______________________ SS#_________________
Address_______________________________________ City__________________ State___ Zip_________
Name____________________________________Title_______________________ SS#_________________
Address_______________________________________ City__________________ State___ Zip_________
Have any principles ever filed bankruptcy? Yes_____ No _____
If yes, Who_____________________ Where______________________________________ When_______
Applicants Primary Suppliers / Credit References
Name_____________________________________________________________________________________
Address_______________________________________ City_________________ State___ Zip_________
ph_____________ fax_____________ e-mail / accounting, required______________________________
Name_____________________________________________________________________________________
Address_______________________________________ City_________________ State___ Zip_________
ph_____________ fax_____________ e-mail / accounting, required______________________________
Name_____________________________________________________________________________________
Address_______________________________________ City_________________ State___ Zip_________
ph_____________ fax_____________ e-mail / accounting, required______________________________
Name_____________________________________________________________________________________
Address_____________________________ _________ City_________________ State____ Zip_________
ph_____________ fax_____________ e-mail / accounting, required______________________________
Applicants Business Banking Information
Bank Name____________________________________________ Account #_________________________
Branch______________________________________________________________ ph___________________
Address_______________________________________ City_________________ State____ Zip_________
Terms of Agreement
Maximum terms to all types of trade: Net 10th
Payment due date by the 10th day of the following month. Buyer agrees to be held liable for a monthly interest charge of 2% of the outstanding debt upon default in payment of any such debt. Interest to accrue from the date of Invoice and will be activated upon the buyers failure to satisfy sellers demand for payment. In the event of any litigation, controversy, claim or dispute between the parties hereto, arising out of or relating to this contract or breach thereof, the prevailing party shall be entitled to recover from the losing party reasonable expense including, without limitation, attorney’s fees and cost.
I (we) certify that the above information is true and correct, and that I (we) will comply with your terms. This signature also authorizes the release of information on my accounts to Rec World Incorporated for credit purposes.
Name of officer______________________________ Title______________________ ph________________
Signature___________________________________ Date____________
Name of officer______________________________ Title______________________ ph________________
Signature___________________________________ Date____________