CFGroup appreciates the opportunity to serve you. In order for us to establish open account terms we ask that you please fill out the following at your earliest convenience.
Legal Name:
D/B/A: Year Started:
Type of Organization:
Proprietorship Partnership Corporation Other, Specify:
Address: For Past ______years
City: State: Zip Code:
Phone No: Fax No:
Former Business Address (if applicable):
No of Employees:
Less than 10 10-50 51-150 Greater than 150
Corporate Officers
Name: Title:
Name: Title:
Name: Title:
References
DUNS #: Federal Tax ID #:
Bank Name: Contact:
Address: Phone No:
Ckg #: Loan #:
Trade References (All references will be contacted by email. Please include Email address.)
1) Name: Fax:
Email: Phone:
2) Name: Fax:
Email: Phone:
3) Name: Fax:
Email: Phone:
4) Name: Fax:
Email: Phone:
Financial Statement Information
Please attach most current and year end: Fiscal Closing Date
Balance Sheet(s) Profit and Loss Statement(s) Cash Flow Statement(s)
Any misrepresentation in this application will be considered evidence of fraud, since this information is the basis for the extending of credit. As an inducement to grant credit, the undersigned warrants that the information submitted is true and correct. In consideration for the extension of credit, said business promises to pay for all purchases within the terms agreed (Net 30) and agrees to pay interest at 1-1/2% per month (18% A.P.R. or the maximum legal rate) on all past due balances. In the event any third parties are employed to collect any outstanding monies owed by said business the undersigned agrees to pay all reasonable and actual collection costs, including collection agency fees, attorney fees and court costs whether or not litigation has commenced, and all costs of litigation incurred if they are required to obtain payment.
I hereby give my Bank and Trade references authorization to release information to CFGroup and any of its subsidiaries.
Name of Business
Print Name Title
Signature Date
Commercial Furniture Group 810 W. Highway 25/70, Newport, TN 37821 Phone: 423-623-0031 Fax: 866-900-0938 Website: www.commercialfurnituregroup.com
Standard Terms and Conditions of sale apply to all orders
The following must be complete if you are claiming a sales tax exemption.
MULTI-JURISDICTION
SALES TAX EXEMPTION CERTIFICATE
Issued to / Address / City / State / Zip CodeCFGroup / 810 W. Highway 25/70 / Newport / TN / 37821
certify that / Name of Firm (Buyer) / Is engaged as a registered
/ Wholesaler
Retailer
Manufacturer
Lessor
Other
/ Street Address or P.O. Box No.
/ City / State / Zip Code
is registered with the below listed states and cities within which your firm would deliver purchases to us and that any such purchases are for wholesale, resale ingredients or components of a new product to be resold, leased, or rented in the normal course of our business. We are in the business of wholesaling, retailing, manufacturing, leasing, or renting.
Product or Services RenderedState / State ID No. / City or State / State Registration or ID No.
City or State / State Registration or ID No. / City or State / State Registration or ID No.
City or State / State Registration or ID No. / City or State / State Registration or ID No.
I further certify that if any property so purchased tax free is used or consumed by the firm as to make it subject to a Sales or Use Tax, we will pay the tax or direct to the proper taxing authority when state law so provides or inform the seller for added tax billing. This certificate shall be part of each order, which may hereafter be given by you, unless otherwise specified, and shall be valid until canceled by us in writing or revoked by the city or state.
General description of products to be purchased from the seller:
I swear or affirm that the information on this form is true and correct as to every material matter.
Authorized Signature (Owner, Partner or Corporate Officer) / Title / Date
Commercial Furniture Group 810 W. Highway 25/70, Newport, TN 37821 Phone: 423-623-0031 Fax: 866-900-0938 Website: www.commercialfurnituregroup.com
Standard Terms and Conditions of sale apply to all orders