Salesperson's #

Application for Credit


7777 First Place
Cleveland, OH 44146
Phone: 440-232-4155 Fax: 440-786-7233

Firm Name A/P Contact ext
Street P.O. Box
City State Zip
Phone Fax
Type of Business Year Established
Proprietor or Owner's Name SS#
If Corporation - Name of Officers?
Previous account with Zenex International? YES NO (if Yes under what name )

REFERENCES:
(Give only names of firms you buy from on a charge basis.)

Name
Street Address
City State Zip
Phone Fax Contact

Name
Street Address
City State Zip
Phone Fax Contact

Name
Street Address
City State Zip
Phone Fax Contact

Bank Name
Branch Address
Branch City State Zip
Phone Fax Contact

All payments shall be made to Zenex International in Cuyahoga County, OH. This agreement shall be deemed to have been made in Cuyahoga County, OH regardless of the order in which the signatures of the parties are affixed hereto or the location of the party at the time the agreement was made. TERMS: We reserve the right to place a limit on the total credit allowed at any time. Accounts not paid within the terms will be placed on a C.O.D. basis. Applicant acknowledges that a service charge of 2% shall be made on all sums due Zenex International which have not been paid according to the invoice terms. Applicant agrees to pay Zenex International any and all collection fees, attorney fees, court costs and filing fees incurred as the result of collecting delinquent account balances. Terms and conditions will be pursuant to the laws of the State of Ohio.

STANDARD TERMS: 1% 10 Days/Net 30 Days, or otherwise as specified on invoice. Subject to 2% monthly finance charge on all past due balances.

Date: Company

Signature of Officer

Title
Check this box to approve your typed name in the above signature box as your signature