Credit Application
complete the following information
print completed form and send to
BrightShades
100 Kreps Rd
North Lima, Ohio 44452
or fax to 330-549-2172
Your name:
Business Name
Business Address
Shipping Address if
different from Business Address
Phone number:
Your email address:
Taxpayer ID#
Please send copy of exemption form to
BrightShades
100 Kreps Rd.
North Lima, Ohio 44452
or Fax to
330-549-2172
Approximate line of
Credit requested
Accounts payable contact
Accounts payable Phone number
Partnership?
Corporation?
Sole Proprietorship?
Address
Telephone
Officers or Principle owners
1
2
3
How Long has customer
been in business
Do you have any creditors who are
demanding payment or threatening suit
yes
If yes please list and give outcome
1
2
Trade References
Name Address City Phone Highest Credit Amount
Name Address City Phone Highest Credit Amount
Bank References
Name Address City Phone Highest Credit Amount
Name Address City Phone Highest Credit Amount
Application For Credit
Customer Acknowledges and warrants that the above information on the application for credit is true and may be
relied upon by BrightShades. If credit is approved a down payment of 50% of the total order is due within 7 days.
The balance of the payment is due in 30 days. If payment is not made when due, interest may be charged and
customer agrees to pay all collection fees and reasonable attorney fees of BrightShades in collection of any sums
due Brightshades or in the enforcement or interpretation of the Master Customer Agreement.
Signature ________________________________________________________
Title ____________________________________________________________
Firm Name _______________________________________________________
Date _______________
Comments: