314.389.6280
info@mwsystems.com
Midwest Systems

Credit Application

    Bill To:

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          Apt# / PO Box
          City
          StatePostal Code

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              ext.

                  Street
                  Apt# / PO Box
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                  StatePostal Code

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                                  Business Facts:

                                                      Corporate Officers:

                                                      Complete the following information for two corporate officers, partners, or individual proprietor.

                                                        First Name
                                                        Last Name

                                                            Street
                                                            Apt# / PO Box
                                                            City
                                                            StatePostal Code

                                                              ext.

                                                                First Name
                                                                Last Name

                                                                    Street
                                                                    Apt# / PO Box
                                                                    City
                                                                    StatePostal Code

                                                                      ext.

                                                                        Bank Information:

                                                                            Street
                                                                            Apt# / PO Box
                                                                            City
                                                                            StatePostal Code

                                                                              ext.

                                                                                ext.

                                                                                    First Name
                                                                                    Last Name

                                                                                        Trade References:

                                                                                        List only those accounts that you have an established line of credit with. No personal references. No COD accounts.

                                                                                          First Name
                                                                                          Last Name

                                                                                            Street
                                                                                            Apt# / PO Box
                                                                                            City
                                                                                            StatePostal Code

                                                                                              ext.

                                                                                                First Name
                                                                                                Last Name

                                                                                                  Street
                                                                                                  Apt# / PO Box
                                                                                                  City
                                                                                                  StatePostal Code

                                                                                                    ext.

                                                                                                      First Name
                                                                                                      Last Name

                                                                                                        Street
                                                                                                        Apt# / PO Box
                                                                                                        City
                                                                                                        StatePostal Code

                                                                                                          ext.

                                                                                                            Agreement:

                                                                                                            AGREEMENT: Parties hereby agree that all purchases of goods and/or services from Midwest Systems are subject to the following terms and conditions:

                                                                                                            1. Once approved, this application constitutes a contract to conduct business between Midwest Systems (hereafter referred to as The Company) and the applicant.
                                                                                                            2. All amounts due for goods and services purchased from The Company are payable (in US Funds) at Midwest Systems, 5911 Hall Street, St. Louis, MO 63147.
                                                                                                            3. Terms are net 30 days, unless otherwise stipulated in writing and agreed to by all parties. If an amount due The Company is not paid within terms, a finance charge of 2% per month of the delinquent balance, or such rate allowable by law, may be added to the invoice amount, and will become due immediately.
                                                                                                            4. Should it become necessary, reasonable attorney's fees, interest, and costs, associated with the collection of past due debts will be paid by the debtor.
                                                                                                            5. Goods and/or services purchased from The Company are not payable in installments.

                                                                                                            RELEASE OF CREDIT INFORMATION. Applicant authorizes The Company to inquire into, and obtain from any bank, lending institution, or credit reference, whether listed on the Credit Application or not, any and all information relating to the applicant's credit worthiness and/or financial condition.

                                                                                                            APPLICABLE LAW. All Transactions arising hereunder shall be governed and interpreted by the laws of the State of Missouri.

                                                                                                              First Name
                                                                                                              Last Name

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