PIPE AND SUPPLY COMPANY, INC.

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APPLICATION FOR CREDIT

Amount Approved	By
Date
Name of Company	Phone
Billing Address
Home Address

How Long in Business?		Corporation	Partnership	Sole Proprietorship
		Other Please Specify

Name of Officers & Principals	Title	Soc. Sec. No.	Birthdate

Type of Business

Contractor License No.
if applicable

Resale No.
if applicable

Attach Resale Card

Taxable


Bank Name	Comm. Pers.	Account Number

Address	City	Phone

Trade References (3)	Name	Address	Phone
1.
2.
3.
4.

I/We declare under penalty of perjury that the foregoing information is true and correct. In the event Triangle Pipe and Supply Company, Inc. shall bring any legal action to collect any amount due form applicant to Triangle Pipe and Supply Company, Inc. applicant shall pay all costs and attorney fees incurred by Triangle Pipe and Supply Company, Inc. in said action. I/We personally and jointly and severally guarantee payment of all sums due Triangle Pipe and Supply Company, Inc. including the cost of all materials puchased by said company or by the undersigned individual and/or delivered to or installed in any real property or improvements thereto owned by either said parties. All accounts are due and payable NET 30 DAYS following Date of Invoice. A service charge of 1 1/2% per month which is an annual percentage rate of 18%, will be charged on all past due accounts.

Date		Company
		By (Title)
Date		*Signature of Applicant
Date		*Signature of Applicant