The Music People! Credit Application
The Music People! Credit Application
The Music People! Credit Application
Tim Lozier
Credit Manager
800-289-8889 x123
F. 860-828-1353
AR@musicpeopleinc.com
CREDIT APPLICATION
TMP Salesperson Name: _________________________________________________________
Requested Terms:
Company Check (COD)
Open Account Security Agreement (Net)
How much credit are you applying for?
< $2,000
$2,000-$5,000
Credit Card
Export
$5,000-$10,000
$10,000+
Federal ID #: _____________________________
Tax Exempt number: ____________________________ Yrs. In Operation: _______
Please send a copy of your tax exempt certificate
YES
Internet Based
Mail Order
Partnership
State/Fed Operation
President
Owner
Partner
Name: ______________________________________________ Date of Birth: _____________
Home Address (Street): _________________________________________________________
City: _________________________________ State: _______________ Zip: _______________
Drivers License # and State: _______________________________ SS #: _________________
Expiration Date:
CVV Code:
Bank Name:
Bank Phone/Fax #:
State:
Zip
Contact:
State:
Lease Expiration:
Zip
AnnualRent:
AT A MINIMUM, THE COMPANY NAME, ACCOUNT # & FAX # MUST BE FILLED IN BY YOU.
Please DO NOT use the following references. These companies do not rate:
TRADE REFERENCES
Company Name #1:
Account #:
Phone:
Fax:
Address (Street):
City:
State:
Zip
Account #:
Phone:
Fax:
Address (Street):
City:
State:
Zip
Account #:
Phone:
Fax:
Address (Street):
City:
State:
Zip
CREDIT/SECURITY AGREEMENT:
The applicant named below hereby applies for credit and supplies the information contained herein, which is warranted to be true and correct, for the
purposes of introducing The Music People, Inc. to extend credit. It is agreed and understood that the undersigned is an authorized agent of the applicant
and is duly empowered to enter into and make binding agreements on its behalf; all invoice balances are due and payable within 30 days of receipt of the
merchandise unless otherwise stated on the invoice; any invoice unpaid after the terms printed on the invoice is subject to a late fee of 1.5% per month;
in the event of default of payment when due, all costs of collection, including attorneys fee, whether suit filed, will be paid by the applicant. The Music
People, Inc. will retain a security interest on the merchandise retained in the applicants place of business to offset any and all unpaid invoices owed The
Music, Inc! This agreement shall be governed exclusively by the Connecticut State Law. Further, Connecticut courts have exclusive jurisdiction to litigate
any and all disputes between applicant and The Music People, Inc! and applicants waives the right to change of venue. You are authorizing us to
conduct a credit search as to the information provided. All the above mentioned in this paragraph and on Page 3 of this Agreement are material parts of
this contract and your signature on this form is acknowledgment and agreement to the content. (JAN 2010)
NAME OF APPLICANT:
DATE:
DATE:
_______________________________________________________________________________________________
I certify that:
is engaged as a registered
_________________
_________________
_________________
_________________
_________________
_________________
and is registered with the below listed states and cities within which your firm would deliver purchases to us and that any such purchases
are for wholesale, resale, ingredients or components of a new product or service1 to be resold, leased, or rented in the normal course of
business. We are in the business of wholesaling, retailing, manufacturing, leasing (renting) the following:
Description of Business: ________________________________________________________________________________________
General description of tangible property or taxable services to be purchased from the seller: __________________________________
___________________________________________________________________________________________________________
State
AL2
AR
AZ22
3
CA1
CO
CT4
DC235
FL
GA6
1,7
HI
ID1,8
IL
IA
KS 24
KY
ME910
MD11
MI 12
MN
State
13
MO14
NE
NV
NJ 1,15
NM
NC25
ND
26
OH16
OK
PA27
17
RI
SC 18
SD
TN
TX19
UT
VT 20
WA
WI21
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
I further certify that if any property or service so purchased tax free is used or consumed by the firm as to make it subject to a Sales or Use
Tax we will pay the tax due directly to the proper taxing authority when state law so provides or inform the seller for added tax billing.
This certificate shall be a part of each order which we may hereafter give to you, unless otherwise specified, and shall be valid until
canceled by us in writing or revoked by the city or state.
Under penalties of perjury, I swear or affirm that the information on this form is true and correct as to every material matter.
Authorized Signature:
_____________________________________________________
(Owner, Partner or Corporate Officer)
Title:
Date:
_____________________________________________________
_____________________________________________________