new credit

POWER SERVICES
CREDIT APPLICATION
Legal Business Name __________________________________________________________
Business Address ____________________City_______________ State______ Zip________
Business Phone ________________ Our Resale Permit Number ______________________
(Please include copy of resale Licenses)
Is PO No. required on invoice? ____ Number of copies required _______________
Type of Business ___________________________ how long in business? ____________
Our license Number __________________________ Our License Type ________________
We except our monthly credit requirements from you to be about $ __________________
How long at this address? ________yrs. IF LESS THAN ONE YEAR IN SAME, PLEASE
GIVE PREVIOUS ADDRESS ____________________________________________________
PARTNERSHIP OR PROPRIETORSHIP:
Name Home Address Phone Social Security #
1. _______________________________________________________________
Spouse: __________________________________________________________
2. _______________________________________________________________
Spouse: __________________________________________________________
CORPORATION:
Correct Corporate Identity _______________________________________________
Title Name Home Address & Phone Social Security #
PRESIDENT ____________________________________________________________
VICE PRESIDENT _______________________________________________________
SECRETARY ___________________________________________________________
TREASURER ___________________________________________________________
DATE OF INCORPORATION _________ STATE OF INCORPORATION_______

PRINCIPAL SUPPLIERS:
1.______________________________________________________________________
2.______________________________________________________________________
3.______________________________________________________________________
4. ______________________________________________________________________
5. ______________________________________________________________________
6. ______________________________________________________________________
14000 S. Broadway Los Angeles, CA 90040
Ph# 800-227-8899, Fax 323-721-3929
Does company own real property? If yes, give address _____________________________
Does individual own real property? If yes, give address ____________________________
Bank ___________________________________ Branch _______________________________
Account Number ________________________ Account in name of ___________________
Bank ___________________________________ Branch _______________________________
Accounts Number _______________________ Account in name of ____________________
TERMS AND CONDITIONS
Power Services reserves the right to limit or withdraw the extension of credit at
any time. All accounts receivable and credit functions are processed through
Power Services’s headquarter in Los Angeles, California. Consequently,
it is agreed that this agreement entered into and to be performed in Los Angeles,
California in the event of suit or legal actions, venue and jurisdiction
will take place in Los Angeles, California and that this will be at the
option of Power Services Applicant (s) give their permission to Power Services
and/or it’s agents to verify and / or supplement the information stated hereon.

AGREEMENT
In the event this Agreement is placed by Power Services in the hands of an
attorney or collection agency after default for enforcement of collection costs,
interest at the rate of 18% per annual, together with reasonable attorney’s fee
including without limitation fees for the successful defense of any cross claim or
counterclaim.
X ____________________________ X_____________________________
(Signature of corporate Officer) (Signature of Corporate Officer)
______________________________ _______________________________
(Print Name) (Print Name)
______________________________ _______________________________
(Date) (Date)
14000 S. Broadway, Los Angeles, CA 90040
Ph# 800-227-8899, Fax 323-721-3929