Credit Application

Business Information

Business Name_* required

Contact Name_* required

Title_* required

Address_* required

City_* required

State_* required

Zip_* required

Accounts Payable Email_* required

Business Type_* required

Telephone_* required

Fax_*

Email_*

Resale Number _*

Resale Number State_*

Federal Tax Id_*

Years In Business_*

D & B#_*

Accounts Payable Phone_*

Accounts Payable Name_*

Owner Information

Full Name

SSN

Address

City

State

Zip

Title Number

Telephone

Fax

Bank Details

Bank Name & Address_*

Contact Name_*

Phone

Fax_*

Checking Account_*

Checking Account 2

Loan Account/Line Of Credit_*

Supplier & Trade Referneces

Trade Name1_*

Trade Contact1_*

Phone 1

Fax 1_*

Email 1_*

Address 1_*

Trade Name 2_*

Trade Contact2_*

Phone 2

Fax 2_*

Email 2_*

Address 2_*

Trade Name3_*

Trade Contact3_*

Phone 3

Fax 3_*

Email 3_*

Address 3_*

W-9 Form ( pdf or jpg format only)

1.AUTHORIZATION TO OBTAIN CREDIT INFORMATION: Applicant warrants all credit and financial information submitted to Lender and/or its assigns it be true and accurate and hereby authorizes all banking institutions and credit reporting agencies to release necessary information via telephone, mail, internet or facsimile as requested /or purposes of making a credit decision. The undersigned individuals specifically authorize Spa World Corp. and its assigns to obtain personal credit bureau reports for the making, extension or renewal of this credit decision or collection of the resulting account. A fax, digital file or photocopy of this authorization shall be as valid as the original.

Agree

2. DEFAULT AGREEMENT AND PRINCIPAL's PERSONAL GUARANTEE To induce Spa World Corp. to grant a purchasing account to Customer, the undersigned Principal hereby conditionally guarantees payment of all present and future Customer obligations to Spa World Corp. within 30 days from the date of the invoice, and to pay a service charge of 1.5% a month on all overdue balances, and agrees to pay all collection costs related to enforcing such guarantee (including attorney's fees at least 15% of amounts due) and waives any right to demand that Spa World Corp. first pursue collection from Customer. Additionally, we agree that all disputes concerning our obligations hereunder shall be resolved by the laws of the State of Florida in the county of Miami Dade and we consent to the exclusive jurisdiction of the state and federal courts sitting in Miami Dade County, in the State of Florida. I further agree that all equipment/product purchased is the property of Spa World Corp. and that Spa World Corp. maintains the right to collect or repossess equipment/product not paid for at the Customer's expense. Executed under seal on the below date on behalf of Customer and by the Principal individually.

Agree

Full Name Required

Date Required

Sales Rep Name Required

CREDIT APPLICATION

Fill out this form and submit for credit approval

Credit Application

Business Information

Owner Information

Bank Details

Supplier & Trade Referneces