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CF-910-02-3.0 Credit Application Form (For client) SPANISH

CF-910-02-3.0 Credit Application Form (For client) SPANISH

CF-910-02-3.0 Credit Application Form (For client) SPANISH

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Corpac Steel Products, Corp.20803 Biscayne Blvd., Suite 5<strong>02</strong>Aventura, FL 33180, USATel. (305) 918 0540Fax. (305) 918 0570APPLICATION FOR CREDITSolicitud de CréditoLegal Name of Business:(Razón Social del Negocio)Business Physical Address: City: State: Zip:(Dirección del Negocio)(Ciudad) (Estado) (Código Postal)Business Billing Address: City: State: Zip:(Dirección de Facturación) (Ciudad) (Estado) (Código Postal)(Utilice una hoja separada para direcciones adicionales)E-mail address:Phone:Facsimile:(Dirección Correo Electrónico) (Teléfono) (Fax)<strong><strong>For</strong>m</strong>er Business Name / DBA:(Nombre anterior del Negocio)Check Legal Status: Propietorship Partnership Corporation Limited Liability Company(Marque estado legal) (Propietario) (Sociedad) (Corporación) (Sociedad de Resp. Ltda.)Is Company Publicly Traded: Yes No If Yes, what Ticker Symbol:(La Compañía está inscrita en Bolsa?) (Si) (No) (Cuál es el Ticker Symbol?)List All Owners, Partners, or Corporate Officers (and titles):(Ennumere a todos los dueños, socios o Directores Corporativos incluyendo los nombres de sus respectivos cargos)State of Incorporation or Registration of Partnership:(Nombre del Estado donde se Incorporó o Registró la Sociedad)Date Incorporated or Established:(Fecha de Incorporación de la Sociedad)Type of Business:(Clase de Negocio)Tax Payer Identification No.:DUNS No.:(Número de Identificación de Contribuyente)Accounts Payable Contact:Phone:Facsimile:(Contacto en Cuentas por Pagar) (Teléfono) (Fax)Taxable: Yes No If Yes, Tax Rate: State: County: City:(Sujeto a Impuestos?) (Si) (No) (Tasa de Impuesto) (Estado) (Condado) (Ciudad)Exempt: Yes No If Yes, Tax Exemption No.:Attach Copy of Exemption Certificate(Exento de Impuestos?) (Si) (No) (Si aplica, Número de Exención de Impuestos) (Adjunte copia del Certificado de Exención)(<strong>Application</strong> will not be processed without this document)(Su solicitud NO podrá ser procesada sin este documento)Banking References:(Referencias Bancarias)Bank Name:(Nombre del Banco)Bank Officer's Name:(Nombre del Oficial del Banco)Account No.:(Número de Cuenta Bancaria)Bank Phone No.:(Teléfono del Banco)Bank Officer's Email:(Email del Oficial del Banco)Bank Fax No.:(Fax del Banco)FINANCE - <strong>Credit</strong> Reference <strong><strong>For</strong>m</strong> <strong>CF</strong>-<strong>910</strong>-<strong>02</strong>, Version <strong>3.0</strong>, 5/19/2011 Page 1 of 3


Corpac Steel Products, Corp.20803 Biscayne Blvd., Suite 5<strong>02</strong>Aventura, FL 33180, USATel. (305) 918 0540Fax. (305) 918 0570APPLICATION FOR CREDITSolicitud de CréditoTrading References:(Referencias Comerciales)Company Name (Nombre de la Compañía)Contact Name (Nombre de Contacto)Contact Name Fax (Fax de Contacto)Contact Name Phone (Teléfono de Contacto)Contact Name Email (Email de Contacto)Company Name (Nombre de la Compañía)Contact Name (Nombre de Contacto)Contact Name Fax (Fax de Contacto) Contact Name Phone (Teléfono de Contacto) Contact Name Email (Email de Contacto)Company Name (Nombre de la Compañía)Contact Name (Nombre de Contacto)Contact Name Fax (Fax de Contacto)Contact Name Phone (Teléfono de Contacto)Contact Name Email (Email de Contacto)Company Name (Nombre de la Compañía)Contact Name (Nombre de Contacto)Contact Name Fax (Fax de Contacto) Contact Name Phone (Teléfono de Contacto) Contact Name Email (Email de Contacto)We herein make application to Corpac Steel Products, Corp. for credit and/or to update and reconfirm our existing accounts and balances with Corpac Steel Products, Corp. Weagree to provide Corpac Steel Products, Corp. with a current financial statement if requested. If credit is granted, we agree to pay all invoices according to the terms stated on eachinvoice. In the event payment is not made and/or this account is referred for collection, we also understand that a late charge on any unpaid balance will be charged at 1.5%monthly or the maximum rate allowed by law. If suit or action by an attorney/collection agency is instituted, we promise to pay reasonable attorney/collection agency fees and costsin said suit or action. It is specifically understood that all billing, accounts receivables and credit functions are processed through Corpac Steel Products, Corp. Corporate Office inNorth Miami Beach, FL. Consequently, it is understood that in the event of suit or action, same shall take place in North Miami Beach, FL or the city, county, state from which theproduct was shipped. We give our permission to Corpac Steel Products, Corp. and/or it’s agents to verify and/or supplement the information stated hereon. We will provide writtennotice to the credit department of Corpac Steel Products, Corp. in the event we sell, transfer, change the ownership, or change the legal structure of our business. Guarantorexpressly waives notice of acceptance of this guarantee and waives diligence on the part of Corpac Steel Products, Corp. in the collection of the indebtedness. It shall not benecessary for Corpac Steel Products, Corp., before enforcing payments by Guarantor of the indebtedness, to first institute suit or pursue or exhaust remedies against obligor, oragainst any security that obligor may have. Further, Corpac Steel Products, Corp. shall have the privilege of granting such renewals and extensions as it may deem proper, andGuarantor waives notice of nonpayment and shall remain obligated for the full amount of the indebtedness, including any extensions of additional credit.By __________________________Owner/Corporate Officers/Co.<strong>For</strong> value resolved, the undersigned agrees to unconditionally guarantee payment of all sums owed pursuant to this Agreement and further agrees to its terms regarding venue andjurisdiction. This is intended to be and is a continuing guarantee and shall not be revoked except by written notice to the credit department of Corpac Steel Products, Corp.The undersigned hereby consent(s) to Corpac Steel Products, Corp. use of a non-business consumer credit report on the undersigned in order to further evaluate the creditworthiness of the undersigned as principal(s), proprietor(s) and/or guarantor(s) in connection with the extension of business credit as contemplated by this credit application. Theundersigned hereby authorize(s) Corpac Steel Products, Corp. to utilize a consumer credit report on the undersigned from time to time in connection with the extension for creditrepresented by this credit application. The undersigned as (an) individual(s) herby knowingly consent to the use of such credit report consistent with the Federal Fair <strong>Credit</strong>Reporting Act as contained in 15 U.S.C. @ 1681 at seq…______________________Guarantor______________________DateBANK REFERENCE AUTHORIZATION - AUTORIZACION DE REFERENCIAS BANCARIASFINANCE - <strong>Credit</strong> Reference <strong><strong>For</strong>m</strong> <strong>CF</strong>-<strong>910</strong>-<strong>02</strong>, Version <strong>3.0</strong>, 5/19/2011 Page 2 of 3


Corpac Steel Products, Corp.20803 Biscayne Blvd., Suite 5<strong>02</strong>Aventura, FL 33180, USATel. (305) 918 0540Fax. (305) 918 0570APPLICATION FOR CREDITSolicitud de CréditoBank Name: Date: Fax:(Nombre del Banco) (Fecha) (Fax)Attention: Phone: Email:(Atención a) (Teléfono) (Email)Our Company,is processing an account application withCorpac Steel Products, Corp. We hereby authorized you to furnish them any bank and/or credit information regarding account(s) with you so that theymay adequately evaluate our company. Your prompt response to this request would be highly appreciated. A facsimile copy of this authorization isvalid as its original.Nuestra Compañía está procesando actualmente una solicitud de cuenta con Corpac Steel Products, Corp. Por la presente quedan autorizados para proveerlescualquier información bancaria o de crédito correspondiente a nuestras cuentas con ustedes para ser evaluados adecuadamente. Apreciamos su pronta respuesta aesta solicitud. Una copia de esta autorización enviada vía fax, es tan válida como su original.Print Name (Nombre Legible)Bank Account Number (1) Número de Cuenta (1)Authorized Signature (Firma Autorizada) Bank Account Number (2) Número de Cuenta (2)BANK VERIFICATION - to be completed by BANKBank Name/Branch:(Nombre del Banco/Sucursal)Name of Office(s):(Nombre de la Oficina)Name of the above Accounts per Bank's Record:(Nombre de las cuentas mencionadas anteriormente de acuerdo con el record del Banco)Type of Accounts: CheckingSavingsPayroll Others(Tipo de Cuentas)(Cheques) (Ahorros) (Nómina)(Otras)Date Opened / Fecha de AperturaCurrent Balance / Balance a la fecha<strong>Credit</strong> Rating / Puntaje de CréditoAverage Daily Balance / Balance Promedio Diario<strong>Credit</strong> lines available and/or in use:(Líneas de Crédito disponibles y/o en uso)Return / NSF Checks(s)? None Yes(Cheques devueltos por Ninguno (Si)fondos insuficientes?)How many?(Cuántos?)E-mail address:Phone:Facsimile:(Dirección Email) (Teléfono) (Fax)Verified by: Title: Date:(Verificado por) (Cargo) (Fecha)Last NSF Date:(Ultima fecha con fondos insuficientes)FAX REQUEST / SOLICITUD VIA FAXUpon completion, Bank Officer please reply to: / Favor enviar esta solicitud cuando esté diligenciada a:Corpac Seet Products, Corp.Fax. (305) 918 057<strong>02</strong>0803 Biscayne Blvd., Suite 5<strong>02</strong>, Aventura, FL 33180, USATel. (305) 918 0540FINANCE - <strong>Credit</strong> Reference <strong><strong>For</strong>m</strong> <strong>CF</strong>-<strong>910</strong>-<strong>02</strong>, Version <strong>3.0</strong>, 5/19/2011 Page 3 of 3

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