STAUF / SERVICE

Credit Application

Complete the STAUF credit application form below.

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Credit application form

Company Name *

First Name *

Last Name *

Phone Number *

First Name *

Last Name *

Phone Number *

First Name *

Last Name *

Phone Number *

First Name *

Last Name

Phone Number *

Shipping Address (Street, City, State, ZIP) *

Billing Address (Street, City, State, ZIP) *

Name of STAUF Representative *

Line of Business *

Years in Business *

Annual Sales *

Have you ever been subject to Bankruptcy Chapter 7, 11 or 13? *YesNo

Reference #1 *

Phone *

Reference #2

Phone

PARTIES HEREBY AGREE THAT ALL PURCHASES MADE ARE SUBJECT TO THE FOLLOWING TERMS AND CONDITIONS: *

I certify the information above is correct and authorize references to release any account information requested.

agree2 *

The undersigned purchaser hereby agrees that all amounts due for goods and/or services purchased from STAUF USA, LLC are payable to STAUF USA, LLC.

agree3 *

The undersigned agrees to pay, in the event the account becomes delinquent and is turned over to an attorney for collection, reasonable attorney's fees, plus all attendant collection costs, plus reasonable interest, and agrees any action or proceeding to enforce any provision of, or based on any right arising out of, this Agreement may be brought against any of the parties in the courts of the State of Tennessee, County of Shelby, or it has or can acquire jurisdiction, in the United States District Court for the Western District of Tennessee, and each of the parties consents to the jurisdiction of such courts (and of the appropriate appellate courts) in any such action or proceeding and waives any objection to venue laid therein. Process in any action or proceeding referred to in the preceding sentence may be served on any party anywhere in the world.

agree4 *

The parties hereby agree that the goods and/or services purchased from STAUF USA, LLC are not payable in installments, but are payable per invoice terms.

agree5 *

The signature below indicates permission to obtain credit information from any source or persons.

Name and Title *

INDIVIDUAL PERSONAL GUARANTEE:

In consideration of STAUF USA, LLC extending credit, the undersigned does hereby individually, jointly, and severally to pay for all goods and/or services supplied to any of us and/or the above named business. In the event it becomes necessary to place the account with an attorney and/or collection agency for collection, we agree to pay all costs of collection including reasonable attorney's fees, plus all attendant collection cost, plus reasonable interest and hereby waive our privilege of being sued in the county of our residence and agree that if a suit is brought, that venue will be in Shelby County, Tennessee at the Option of STAUF USA, LLC. The undersigned agrees any action or proceeding to enforce any provision of, or based on any right arising out of, this Agreement may be brought against any of the parties in the courts of the State of Tennessee, County of Shelby, or it has or can acquire jurisdiction, in the United States District Court for the Western District of Tennessee, and each of the parties consents to the jurisdiction of such courts (and of the appropriate appellate courts) in any such action or proceeding and waives any objection to venue laid therein. Process in any action or proceeding referred to in the preceding sentence may be served on any party anywhere in the world.

Name and Title

Email Address *

DUNS Number

Credit Requested *

Federal Tax ID *

Email *

Date *

Date

Please do not fill in this field.

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(901) 820-0007
1-866-GLUE-USA