Spokane House of Hose Credit Application

Please fill out the application below. When you have completed the application, simply print the form and fax it to HOH Sales 1-800-541-4673.
Step 1 - General Information:
Name:
(Name under which account is to be carried.)
Nature of Business:
Phone:
Fax:
Step 2 - Billing Address:
Address:
City:
State:
Zip:
Step 3 - Shipping Address:
Address:
City:
State:
Zip:
Step 4 - Owner(s)/Corporate Officer(s) Information:
Name:
Home Address:
City:
State:
Zip:
Social Security #:
Name2:
Home Address2:
City2:
State2:
Zip2:
Social Security #2:
Step 5 - Business Information:
How many Years in Business?        
Is Business Incorporated?            YesNo   
Is a Purchase Order Required?    YesNo
Do You Accept Backorders?       YesNo
Step 6 - Reference Information:
Bank:
Bank Address:
Contact Person:

Trade References Currently Buying From (Please provide 5)
Reference 1:
Address 1:
(Please give complete mailing address.)
 
Reference 2:
Address 2:
(Please give complete mailing address.)
 
Reference 3:
Address 3:
(Please give complete mailing address.)
 
Reference 4:
Address 4:
(Please give complete mailing address.)
 
Reference 5:
Address 5:
(Please give complete mailing address.)
 
I understand that my account is to be paid in full by the 10th of each month. Accounts with past due balances are subject to 1½% per month finance charge (18% per annum). In the event collection efforts become necessary I agree to pay all collection costs.

Signature:

Date: