Bill To:
Mailing Address:
City, State, Zip:
Tel:

Ship To:
Street Address:
City, State, Zip:

Type of Business:
How Long in Business:
Normal Business Hours:
Accounts Payable Contact:
Accounts Payable Email:

Type of Organization:
County:
State:
Tax Exempt?YesNo
Tax ID#
What Sales Tax Rate do you Pay?
*Any sales tax exemption form must be submitted.
*Must supply copy of certificate to be exempt.

Who in your company will have responsibility and authority to:
1. Issue purchase orders or place direct orders:
2. Require purchase order numbers:
3. Authorize and process timely payment of invoices:

Bank:
Address:
Branch:
Contact:

Credit References *Please list company name, address, telephone and contact

PLEASE ATTACH A COPY OF YOUR MOST RECENT FINANCIAL STATEMENT.Hunter Oil Co. will use this statement solely for the purpose of credit evaluation, and will hold it in the strictest of confidence. PLEASE READ THE FOLLOWING CAREFULLY BEFORE SIGNING: Credit terms are printed on each invoice. The customer acknowledges that for and in consideration of the extensions of credit made by HunterOil Company, if its invoices are not paid by the net due date of such invoice then it shall become delinquent and:
(1) A late charge of one and three-quarters percent (1 3/4%) per month may be added to the unpaid balance until that month,s delinquency is fuly paid. Once a delinquency occurs Hunter Oil Company has no further obiligation to extend credit, and
(2) That if it becomes necessary for this account to be turned over for collection, the undersigned will pay in addition to the unpaid balance and late charges, any and all costs of collection and a reasonable attorney’s fee.
(3) Title to all goods or their proceeds purchased pursuant to this account shall remain in Hunter Oil Company until the account is fully paid.
The undersigned certifies to Hunter Oil Company that the foregoing information has been supplied truthfully,, accurately and voluntarily, and hereby authorizes Hunter to investigate this firm’s creditworthiness, credit history and financial responsibility through any reasonable means, including direct contact with past and present creditors, and also authorizes banks and other financial institutions to give information to Hunter in connection with this transaction about its savings and checking accounts and loans.
First and Last Name:

Signature:Sign Here using your mouse of touchscreen