Waters Technologies Corporation

CREDIT APPLICATION

FIRM NAME / DATE
D/B/A / TELEPHONE
ADDRESS / FAX
CITY / STATE/PROVINCE / ZIP CODE / COUNTRY
PO BOX / CITY / STATE/PROVINCE / ZIP CODE
PARENT IF SUBSIDARY/DIVISION
ADDRESS / CITY / STATE/PROVINCE / ZIP CODE
TAX EXEMPT#(ATTACH A COPY OF CERTIFICATE TO THIS FORM. / COUNTRY
FEDERAL ID # / HOW LONG IN BUSINESS
 CORPORATION /  PARTNERSHIP /  SOLE PROPRIETER
SIC CODE

PROPRIETOR, PARTNERS, OR OFFICERS

NAME
TITLE / HOME ADDRESS / HOME PHONE
NAME
TITLE / HOME ADDRESS / HOME PHONE

TRADE REFERENCES

NAME / ADDRESS / STATE
PROVINCE / ZIP CODE / TELEPHONE
FAX

BANK REFERENCES

NAME / ADDRESS / PHONE
BRANCH / CITY / STATE/PROVINCE / ZIP CODE / FAX
NAME OF ACCOUNT OFFICER / ACCOUNT NUMBER / ACCOUNT TYPE
 COMMERCIAL /  SAVINGS /  OTHER
NAME / ADDRESS / PHONE
BRANCH / CITY / STATE/PROVINCE / ZIP CODE / FAX
NAME OF ACCOUNT OFFICER / ACCOUNT NUMBER / ACCOUNT TYPE
 COMMERCIAL /  SAVINGS /  OTHER

BILLING INFORMATION AS IT WILL APPEAR ON PURCHASE ORDERS

Line 1
Line2
Line 3
Line 4

Accounts Payable Contact Information

CONTACT NAME / TELEPHONE / FAX / EMAIL

Authorized Buyers

List the names of individuals who are authorized to purchase for your company. If no names are provided, Waters Technologies Corporation will assume that any person presenting as an employee of the company will have authorization to purchase.

CONTACT NAME / TELEPHONE / FAX / EMAIL
CONTACT NAME / TELEPHONE / FAX / EMAIL

Please attach financial statements for previous 2 years.

The Undersigned agrees the above information is submitted for the purpose of obtaining credit from Waters Technologies Corporation/Waters Ltd, the Company, and attests to the accuracy of the above information and realizes that both business and personal history may be investigated.

The credit terms the Company extends to its’ customers is NET 30 Days from date of invoice subject to credit approval and undersigned agrees to make payment within these terms. The undersigned agrees that this document governs credit terms for all transactions between applicant and the Company and can only be changed in writing by the Company. The Company reserves its’ right, at its’ sole discretion and without notice, to cancel all available credit and refuse to make future advances.

The Undersigned agrees that any amount not paid within 30 days of invoice date will carry interest at the rate of 1 1/2%per month, both before and after judgment, and further agrees to pay all costs incurred in collection, includingattorney’s fees in the amount of 1/3 of the total balance due if this account is placed with an attorney for collection,whether suit is filed or not.

A service charge of one-and-one-half percent (1½%) per month or eighteen percent (18%) per annum may be assessed on delinquent invoices but not to at any time exceed the highest legal rate of interest legally allowed.

In the event it becomes necessary for the Company to incur collection costs or institute suit to collect any amount due under this agreement, the undersign agrees to pay such additional collections costs, charges and expenses, including reasonable attorney's fees if the account is placed in the hands of an attorney for collection.

The Undersigned understands that we must notify the Company in writing and by certified mail of any change in ownership, the name of the business or structure of the business under which credit is established.

I hereby authorize bank named herein to release information requested for the purpose of obtaining and/or reviewing credit.

The person executing this agreement has the authority to bind the customer and is authorized by the customer to enter into the credit application terms and conditions.

Authorized Signature Title

Printed NameDate

To assist you in setting us up in your system please note the following:

Forward remittances to:All Accounts Receivable and Credit

inquires should be directed to:

US Customers:Canadian Customers:

Waters Technologies CorporationWaters Limited.Waters Technologies Corporation

Dept CH 14373C/O Th1002Account Receivable

Palatine, Il 60055-4373PO Box 4283, Station A34 Maple St.

USAToronto, ON M5W 5W6Milford, MA01757-3696

CanadaUSA

International customers will be provided with remittance advice at time of invoicing.

Accounts Receivable general telephone line - 1-800-252-4752 ext 8217 or for international customers 508-482-8217

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