GlassCraft Dealer Credit Application

2002 Brittmoore Road Houston, Tx 77043

National Ph.# 800-766-2196 Local Ph.# 713-690-8282 Fax# 713-690-9994 Email: Accounting@glasscraft.net

Credit Application Terms: Net 30 from date of shipment.

Procedures Please use this form when applying for credit. Fillout requested information. It is imperative that you complete the credit application and include valid references and fax numbers. Incomplete information or lack of information can prolong the approval time and could result in denial of credit. Creditt verification can take up to four weeks depending on how quickly your references respond to us. In order for the application to be complete, you must check all boxes and sign and date where indicated. We will review the credit application once we have received all references and bank information. Upon review of information we have received, we will mail your company a letter stating the results of the credit application. Mailing Address Company Name Date Address City State Zip Telephone Fax Email Billing/Shipping Address (if different, complete) Billing/Shipping Contact Telephone Fax Email Billing Address City State Zip Shipping Address City State Zip Check One: o Corporation o Partnership o Individual Years in Business Number of Employees Principal’s Name Home Address Home Ph. # City State Zip Business References (List accounts with whom you have had for more than one year) 1. Company Name Address City State Zip Telephone Fax Email 2. Company Name Address City State Zip Telephone Fax Email 3. Company Name Address City State Zip Telephone Fax Email Bank Name Address City State Zip Telephone Fax Email Account # I certify that all information on this application is correct. I personally assume full responsibility for all charges made to my company’s account. I personally guarantee the full performance of the firm, whether a corporation, partnership, or otherwise, of all debts and obligations to GlassCraft Door Corporation, and agree to pay within the terms. I understand that if legal proceedings become necessary to collect monies owed, all court cost, legal fees and attorney fees, an interest of 18% per annum will be added to the amount owed GlassCraft Door Corporation, and will be paid by our firm, and I agree that the venue of these legal proceedings shall be Houston, Harris County, Texas. In addition, I authorize the above firms to release to Glass Craft Door Corporation any information required for the establishment of credit. Signed: Title: DO NOT WRITE IN THIS SPACE Date Received: References Checked By: Credit Limit: Credit Approved By: Date Approved: Letter Mailed:

PLEASE NOTE: The ability to submit this form using the Submit button may be limited by your computer setup. If you are unable to submit the form using the Submit button. Please save the file to your computer and send it to accounting@glasscraft.net

SUBMIT THIS FORM: ■ Email to: accounting@glasscraft.net ■ Fax to: 713-690-9994

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