Service Wholesale, Inc.

Complete your Customer Profile/Credit Application online and we'll send you a "Get Acquainted" packet (catalog, pricer, current specials, etc) via UPS!

Required fields indicated by (*).

*Company Name:

*Your Name:

*Your Title:

Billing Address:

Suite:

*Street: *Phone:

*City, *State: *Fax:

*Zip: *Email:

Shipping Address (if Different):
(Note: An annual volume great than $4,000 is required to carry back orders.)

Suite:

Street: Carry Backorders: Yes No

City, State: Cancel Backorders: Yes No

Zip: SWI Rep:

Personnel:

*Owner/Title: *Manager/Title:

*Buyer/Contact: *Acct. Payable:

*Buyer Phone: *Acct. Pay.Ph:

Business Information:

Bookstore Teacher's Store Printer/Blue Printer Jewelers

Bookstore,K-12 Mailing Store Drug Store News Stand

Office Supply/
Stationery Store Art/Craft Store Card/Gift Shop Scrapbook Store

Other

Business Structure:

Corporation Partnership Sole Proprietorship Other

*Federal Tax ID#: *State Vendors lic.#:

*Years in Business:

Bank Information:

Credit Card:

Type/Exp.Date:

(To be considered for a credit line, the following bank and relevant trade reference information must be filled out completely; otherwise, the account will be set up as Credit Card Only. (Credit cards accepted: Mastercard, Visa, American Express).

Contact Name: Acct. Number:

Bank Name: Phone:

Street Address: Fax:

City, State: Zip:

Trade References:

Trade Reference #1:

Company: Acct. Number:

Suite: Phone:

Address: Fax:

City, State: Zip:

Trade Reference #2:

Company: Acct. Number:

Suite: Phone:

Address: Fax:

City, State: Zip:

Trade Reference #3:

Company: Acct. Number:

Suite: Phone:

Address: Fax:

City, State: Zip:

Trade Reference #4:

Company: Acct. Number:

Suite: Phone:

Address: Fax:

City, State: Zip:

By clicking SUBMIT, applicant acknowledges that all data and information is representative, true and accurate. Applicant also, hereby, acknowledges that all invoices and monthly statements rendered by Service Wholesale, constitute evidence of applicant's indebtedness on its open account and that late or finance charges shall be assessed in the amount of 1.5% per month (18% per annum) on all delinquent balances due until paid in full. Applicant does further represent and certify that the credit terms and other conditions of its open account with Service Wholesale have been explained and are fully understood and that in the event applicant's account is ever placed in legal counsel for enforcement of collection, applicant does further agree and promise to pay all expenses for collection, including reasonable attorney's fees incurred by Service Wholesale. Merchandise billed remain the property of Service Wholesale until paid for except as sold in the normal course of business. Note: Returned goods will not be accepted or credited by Service Wholesale unless previously authorized and returnable.

Note: Indicating "YES" below acknowledges your understanding and agreement with the criteria listed for establishing an account with Service Wholesale, Inc.

Electronic Permission to Release Customer Information Yes No

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