Business Financial Responsibility Application Date * MM DD YYYY Name of Company Principal Responsible for Business Transactions * First Name Last Name Title * Name of Business * Phone * (###) ### #### Email * Resale Account * Yes No Resale Tax I.D. Number If you selected Yes to Resale Account you must provide a Resale Tax I.D. Number Address * Address 1 Address 2 City State/Province Zip/Postal Code Country TERMS: All new account terms are 50% Deposit / Balance on Receipt. Accounts not paid by term date are subject to a 3% monthly finance charge. Items that are not able to be installed or delivered due to the delay of the consumer are considered complete. Upon Installation items that are not able to be installed due to delay of the consumer will be charged with additional fees for additional days of delivery and installation. Credit Card payments over $1000.00 are subject to a 2% surcharge. Payments made within 10 days of Order Date will not be charged a surcharge. We accept Visa, Master Card, Discover, Amex and Checks. Please make out checks to : Creative Interior Imagery Term Request: You may request a different terms by selecting an option below. All new account terms are 50% Deposit / Balance on Receipt until term request is reviewed. Prepay On Receipt 50% Deposit / Balance on Receipt Net 30 50% Deposit / Net 30 Net 45 Initial Below * By Initialing Below you agree with all the information above. Thank you!
