Jamplast, Inc. 636-238-2100

281 Clarkson Road, Suite 102 fax636-238-2101

Ellisville, MO 63011

APPLICATION FOR CREDIT ON ACCOUNT

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Company Name: Click here to enter text.

Billing Address: Click here to enter text.

Shipping Address: Click here to enter text.

Telephone No.: Click here to enter text.

Fax No.: Click here to enter text.

Business Structure: Choose an item._____ Corporation_____ Partnership_____ Proprietor

Purchase Orders Required: Choose an item.

Person(s) authorized to place orders: Click here to enter text.

A/P Contact/Email/Phone: Click here to enter text.

Federal Tax ID: Click here to enter text.

Dun& Bradstreet ID: Click here to enter text.

Tax Exempt: Choose an item. _____Yes (Attach tax exempt certificate) _____No

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Banking Information:

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Acct No.: Click here to enter text.

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I authorize you to release information on our above account as requested by Jamplast, Inc.

(Signature of authorized signer on the account) -

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Trade References:

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Credit Agreement:

I represent that the above information is true and is given to induce to extend credit to the applicant. My company and I authorize to make such credit investigation as sees fit, including contacting the above trade references and banks and obtaining credit reports. My company and I authorize all trade references, banks, and credit reporting agencies to disclose to any and all information concerning the financial and credit history of my company.

Invoices are dated the day of shipment, and due in full, 30 days after this date, unless stated/agreed otherwise (if credit has been granted). Payment can be made in the form of a company check, cashier’s check, money order, or electronic funds transfer (call for account information) and remitted to the address below. A finance charge of 1.5% per month (18% annually) can be added to all invoices not paid within terms. Sales discounts, if any, can be taken only if payment has been received by the discount date. Jamplast, Inc. reserves the right to refuse any sales discounts wrongfully taken. The purchaser must notify Jamplast, Inc. of any pricing discrepancies, short weights, or other billing concerns within seven (7) days of receipt of shipment.

Upon acceptance of the goods provided for hereunder, the purchaser acknowledges and agrees, that Jamplast, Inc.’s interests in the shipped goods is a secured interest, as defined by the Uniform Commercial Code, as amended, and that Jamplast, Inc. shall have a continuing security interest in the goods and shall be entitled to all rights, remedies, and priorities, until this invoice shall be paid in full.

Jamplast, Inc. is entitled to recover reasonable costs and attorney’s fees for any collection efforts that Jamplast, Inc. incurs in order to collect any sums due under the invoice.

This agreement has been entered into the state of Missouri and shall be construed in accordance with and governed by the laws of the state of Missouri. Furthermore, Jamplast has the right to choose where to file suit for non-payment in either the buyer’s county or St. Louis County Circuit Court and/or the Federal District Court, Eastern District of Missouri.

In addition, the undersigned, in consideration of the extension of credit by Jamplast, Inc. to the Company named in this credit application (the Company), which credit will directly benefit the undersigned, hereby gives Jamplast, Inc. this unconditional personal guarantee of payment and collection when such amounts are due and payable with respect to any and all credit extended by Jamplast, Inc. to the Company including interest, costs of collections, court costs, and reasonable attorney’s fees.

Authorized signature:
Printed name:
Date: / Title:

Rev. 11/2014 1 of 2