Western Supplies, Inc.
PO Box 551
3601 Central Freeway
Wichita Falls, TX 76307
Phone: 940-855-3401
Fax: 940-855-7692
Application for Account
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Billing
Shipping
Please provide a list of major suppliers (including fax numbers) you have open credit with:
Major Supplier (1)
Major Supplier (2)
Major Supplier (3)
Major Supplier (4)
Major Supplier (5)
Bank Information
We understand that the terms of sale require payment on or before the DUE DATE and agree to meet those terms. Delinquent invoices are subject to a late fee of 1 1/2 % per month on the outstanding balance. All invoices are payable at PO Box 551, Wichita Falls, Tx. Should legal action be required in connection with the collection of any account due from the undersigned, the undersigned agrees to pay reasonable attorney fees, collection costs and all court costs incurred with any such proceeding. This agreement shall be interpreted under the laws of the State of Texas. Venue for any action brought by Western Supplies, Inc. to enforce any terms of this agreement, shall be in Wichita county, at the option of Western Supplies, Inc. This information is for the purpose of obtaining credit and is warranted to be true. I/We hereby authorize Western Supplies, Inc. to investigate the references listed pertaining to my/our credit and financial credit and financial responsibility.
Please list the names and positions of two company representatives who are authorizing this application
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