T. 866-460-2265 F. 866-460-2265
228 Main Street Suite 134 – Staten Island, NY 10307
Email: [email protected]
Web: www.novacreations-mfg.com
Credit Application
First Name: ___________________
Last Name:
Title/position
SS#/Bus. Tax ID #
Business Name:
Bus. Phone
Fax
Cell
Email (Personal):
E-mail (Bus.)
Web
Business/organization location________________________________________________________________________
City
State
Zip
Billing Address: ____________________________________________________________________________________
City
State
Zip
Shipping Address (if different from billing)
City
State
Zip
Business Product / Service Description: __________________________________________________________
Financial Institution Name & address: _____________________________ ______________________________
Account #_________________________________________
Legal Status of business: (check only one)
[ ] Sole Proprietorship
[ ] Corporation (State of
)
[ ] Partnership
Terms: three pre-paid orders required before credit is established. Credit accounts are Net 2/10, N30, Interest on past
due balances is 15% per annum or 1.25% per month. Client is fully responsible for any collections and efforts made to
receive full payment. Nova Creations Enterprise reserve the right to refuse any further orders until past due balances
are paid. Tripe A companies can receive credit upon approval based on letter of credit from financial institutions.
By signing below, I warrant that I am a principal of this company. I also accept Nova Creations Enterprise’s credit
terms. I acknowledge that I have read and accept Nova Creations Enterprise General Terms and Conditions.
Signed
Date