Wharton Hardware & Supply Corp. Credit Application
Wharton Contractors Equipment Corp.
7724 Crescent Blvd., Pennsauken, NJ 08110
Ph: 856-662-6935 Ph: 215-925-8800 Fax: 856-662-6347 Page 1
Note: Please Complete All 4 Pages, Sign Page 2 & 3. Thank You!
Company Name ______Phone # (_____) ______
Street Address______P.O. Box ______
City______State______Zip Code______
Fax # (______)______Website:______E-Mail:______
List Officers Of Company
Home Address President ______Home Phone # (_____) ______
Home Address ______City ______State ______
Vice President ______Home Phone # (_____) ______
Home Address______City ______State ______
Sec. Treasurer______Home Phone # (_____) ______
Home Address ______City ______State ______
How long has your company been in business? ______
What type of business? ______
If your company is less than two years old, list the name, address and the type of business it is related to.
Name ______
Address ______Type ______
Credit References
Business References Must Be Hardware, Rental or Supply House
Name Address Phone Number Fax Number Account Number
1. ______
2. ______
3. ______
4. ______
Original Application Must Be Mailed!
Wharton Hardware & Supply Corp.
Wharton Contractors Equipment Corp.
7724 Crescent Blvd., Pennsauken, NJ 08110
Ph: 856-662-6935 Ph: 215-925-8800 Fax: 856-662-6347Page 2
List Job Name and Address:
______
Which Best Describes Your Business: (Circle)
1. Building Contractor 2. Carpenter 3. Concrete 4. Demolition
5. Drainage 6. Drywall 7. Electrical 8. Excavating
9. General Contractor 10. Home Builder 11. Landscape 12. Mason
13. Home Improvements 14. Mechanical 15. Painting 16. Pipe Line
17. Plumbing 18. Roofing 19. Sewer 20. Utility
21. Waterproofing Other:______
Do you require a purchase order? (Circle) Yes / No If so, circle only one: Written or Verbal
Amount of credit desired? $ ______
Name of person (s) we are to contact for sales calls: ______
I agree to pay my account by the following terms: NET 30 Days. In the event that any balance owed to
Wharton Hardware & Supply Corp. and/or Wharton Contractors Equipment Corp. IS NOT SATISFIED
AND A LAW SUIT IS INSTITUTED, THEN THE DEBTOR SHALL BE RESPONSIBLE TO PAY,
IN ADDITION TO THE BALANCE OWED, A THIRTY-THREE PERCENT (33%) ATTORNEYS FEE,
INTEREST AND COURT COST. THIS APPLICATION MUST BE SIGNED BY AN OFFICER OF THE
COMPANY.
Signature______Title ______
Date ______Federal ID# or SS#______
I personally guarantee payment of the balance due to Wharton Hardware & Supply Corp. and/or
Wharton Contractors Equipment Corp. and I personally guarantee payment of any additional charges as
enumerated above.
Signature ______Title ______
Date ______Social Security # ______
Wharton Hardware & Supply Corp., and/or Wharton Contractors Equipment Corp. reserves the right to
refuse this application for any reason including but not limited to the giving of improper or fraudulent
information. Wharton reserves the right to check a company and/or an individuals credit. By signing this
agreement, you hereby give your written consent to same.
Wharton Hardware & Supply Corp.
Wharton Contractors Equipment Corp.
7724 Crescent Blvd., Pennsauken, NJ 08110
Ph: 856-662-6935 Ph: 215-925-8800 Fax: 856-662-6347Page 3
Authorization To Release Bank Information
In order for us to process your credit application, we must obtain credit information from your bank. However,
many banks will not give credit information by phone and require the request in writing. In Addition, most banks
require your authorization in writing before they will release the credit information. Therefore, we require that
you complete the form below, allowing your bank to release the credit information.
NOTE: Please complete and sign or the bank will not release the credit information. Thank you!
I hereby authorize,
Name of Bank: ______
Bank Address: ______
Bank Phone # ______
Name of Account: ______
Account Number: ______
To release all necessary credit information to Wharton Hardware & Supply Corp. and/or
Wharton Contractors Equipment Corp.
Company Name: ______
Authorized Agent (Print): ______
Signature: ______
Title: ______
Date: ______
For Office Use Only
Approval ______
Denied ______
Date ______
Credit Limit ______
Wharton Hardware & Supply Corp.
Wharton Contractors Equipment Corp.
7724 Crescent Blvd., Pennsauken, NJ 08110
Ph: 856-662-6935 Ph: 215-925-8800 Fax: 856-662-6347Page 4
Questionnaire
The following is a questionnaire developed to obtain a general idea for new companies and their needs,
regarding materials, job locations, etc. This information will help expedite the process for your credit approval.
Please complete this questionnaire and attach it to your credit application. Thank you!
1.)How was your company referred for credit with Wharton Hardware & Supply Corp.?
2.) What type of materials/items will your company be purchasing?
3.) What type of job will your company be working on?
4.) Is the job bonded? If so, who is the prime or general contractor?
______
5.) Is the job tax exempt? (If so, a tax exemption certificate is mandatory, you will be expected to pay
taxes on materials purchased until the form is remitted.)
6.) Will this be the only job your company will be working on in NJ, PA, and DE area? ______
If not, please list other job locations.
______
7.)Would you like to receive notice of specials and sales? If yes, please provide e-mail address: ______
______