Entertainment Systems, Inc.
14741 Carmenita Rd. Norwalk, California 90650 · Tel: 562.407.1717 · Fax: 562.407.1718 · www.savv.com
APPLICATION FOR CREDIT
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Company’s Legal Name Store Name/DBA
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Billing Address City State Zip Code
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Shipping Address (please attach list of additional locations) City State Zip Code
(_____) _____-______(_____) _____-______(_____) _____-______
Office Phone No. Fax No. Cell. Phone No. E-Mail Address
GENERAL BUSINESS INFORMATIONOwnership: (check one) [ ]-Proprietorship [ ]-Partnership [ ]-Corporation [ ]-Other ______
Primary Officers or Principals:
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Name/Title Name/Title Name/Title
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Social Security # Social Security # Social Security #
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Home Phone No. Home Phone No. Home Phone No.
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Date Business Started (present owner) Date Business Started (former owner) Years at Present Address (under legal name)
Has this Business or any of its owner’s principals ever filed for protection under any of the federal bankruptcy laws?
[ ]-Yes [ ]-No If Yes, please explains circumstances: ______
______(______)______-______/______/______
Name of Landlord Phone Number Date lease expires
______(______)______-______Name of Hazard Insurance Carrier Phone Number
Is your warehouse secured? [ ] - Yes [ ] – No If Yes, how? ______
FINANCIAL INFORMATIONFiscal year end:______Federal Tax I.D. #______State Resale #______
Do you have outstanding UCC’s? [ ]-Yes [ ]-No Are financial statements available? [ ]-Yes [ ]-No
Name of person who prepares financial statement:______Phone #______
Name of person who handles Accounts payable:______Phone #______
$______$______$______
Estimated Monthly purchases Amount of First Order Credit line required
TRADE REFERENCES______
Company Contact Phone # Fax #
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Company Contact Phone # Fax #
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Company Contact Phone # Fax #
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Company Contact Phone # Fax #
The undersigned hereby certifies that the information stated on this credit application is true and correct. The undersigned hereby authorizes SAVV Entertainment Systems., Inc to make such inquires that are necessary to obtain credit information and consents that this information may be investigated at any time.
The undersigned agrees to pay any amount owed to SAVV Entertainment Systems, Inc., within the terms stated on invoice. Upon failure of the undersigned to pay any indebtedness due to SAVV Entertainment Systems, Inc., SAVV Entertainment Systems, Inc., may declare the entire balance of all indebtedness in default. In this event upon notice to the undersigned, the entire balance of all indebtedness shall become immediately due.
In the event it becomes necessary to retain the services of an attorney, or to institute legal proceedings for the collection of any amounts owed to SAVV Entertainment Systems, Inc., the undersigned promises to pay all costs together with reasonable attorney’s fees incurred to collect the indebtedness and agrees that venue and jurisdiction of such legal proceedings shall take place in Norwalk, California or in the judicial district where shipment originates at the option of SAVV Entertainment Systems, Inc.
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Date Owner’s name Signature
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Date Owner’s name Signature
Entertainment Systems, Inc.
14741 Carmenita Rd. Norwalk, California 90650 · Tel: 562.407.1717 · Fax: 562.407.1718 · www.savv.com
BANK INFORMATION RELEASE FORM
Bank Name:______Attention______.Address: ______. Street City State Zip
Phone No. (______) ______-______. Fax No.(______) ______-______.
CUSTOMER SUPPLIED BANK INFORMATION
Company Name______DBA______.Address______.
Street City State Zip Code
Phone No. (______) ______-______. Fax No. (______) ______-______.
Account Number: ______Type of Account______.
I, ______, give ______Bank PERMISSION TO
release requested information to SAVV ENTERTAINMENT SYSTEMS, Inc.
APPLICANTS Signature: ______Date: ______/______/______
For BANK use ONLY – Applicant DO NOT fill out below
INFORMATION REQUESTED FROM BANK
Please provide bank credit information on the account above. This information is requested for use in the extension of credit for business purposes only and will be held in strict confidence.Date account Opened: _____/_____/_____ Average monthly balance: $______
Number of NSF checks in last six months: ______How many stop payments in last six months: ______
Line of Credit Extended: { } Yes { } No If yes, how much $______
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Name and Title of Person providing information: Signature