Toll Free: 800-940-3485 Local: 813-752-3485 Fax  813-752-8064

Application for Credit

Name of Firm

 Or Individual: _____________________________________

Address: _________________________________________

City: ________________State: ______________Zip:_______

Phone Number:_____________         Fax Number:__________________

E-Mail:___________________

Florida Agriculture Number:__________ Amount $__________

Ownership Information

Corporation?        Yes           No  

If yes, when was the company incorporated? _____/_____/_____

Partnership?                  Yes           No  

Individual?               Yes           No  

Name(s) of Principal(s):______________________________________

Financial Information

Bank:___________________________________________

Address:_________________________________________

City:______________State:________________  Zip:_______

Phone: ______________________     Fax:________________________

All information provided by you on this credit application is kept strictly confidential. It will only be used for the sole purpose of establishing credit for your business.

References

We required at least (3) nurseries as reference.

1.  Name:________________ 2.  Name: _________________

     Phone:________________      Phone:_________________

     Fax:__________________      Fax:___________________

3.  Name:________________ 4.  Name:_________________

     Phone:________________      Phone:_________________

     Fax:__________________      Fax:___________________

Credit Terms

(read carefully and please sign below)

Terms are Net 30, unless otherwise stated. All invoices are due for payment 30 days after dated invoice is received. Approved credit accounts may be

Suspended at anytime for delinquent payment, being over credit or any other reason management feels it is necessary to do so. A service charge of $36.50 will be charge on all return checks. Although we do not normally asses finance charges, we reserve the right to do so on accounts that become severely overdue. Collection cost will be assessed and charge when collection services are needed.

Having read and understand the above credit terms, I certify that all the information on this form is correct. I fully understand and agree with the credit terms and agree to proper payment in consideration of extended credit. I understand that no credit will be approved until I have completed this form in its entirety and have received in writing that credit has been established to me from Boone’s Wholesale Nursery, Inc.

Signature: _________________________   Title:__________________

Name:_____________________________________

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