Credit Application

If yes, you must include a copy of your current state, county and municipality exemption certificate. Without copies of tax exemption certificate, tax will be added. You can attach your certificate below:

    Credit cards are accepted for COD sales only and will not be accepted for payment on credit accounts.

    Business Credit References

    RELEASE OF FINANCIAL DATA: I HEREBY AGREE THAT I GRANT OUR CREDITORS AUTHORITY TO PROVIDE CREDIT INFORMATION TO EMPIRE STAPLE COMPANY.

    CREDIT TERMS:

    1. As stated upon invoices issued by Empire Staple Co.
    2. Due on the 10th of the month following invoice date, unless Empire’s Credit Manager makes prior approval of differing terms.
    3. Interest on past due amounts at the rate of 1.50% per month (18% APR) on all past due amounts.
    4. Reasonable attorney fees, court cost and cost of collection incurred by Empire to be paid in the event any collection action is necessary.
    5. Checks returned unpaid, for any reason, are subject to a $30.00 return fee.
    6. Should suit be brought to collect any outstanding balances, Denver, Colorado shall be the proper venue for such action.
    7. Should Empire approve this application, all subsequent decisions with respect to the extension or continuation of such credit shall be at the sole discretion of Empire. Further, Empire, may change the credit terms to a COD or COD (cash only) account or terminate any credit extended hereunder, whenever Empire believes, in its sole discretion, it is in it’s best interest to do so.

    AGREEMENT TO CREDIT TERMS: Applicant hereby declares that all the above information is true and correct and is made for the direct purpose of obtaining Empire Staple Co.’s agreement to sell goods, merchandise, and services on open account as above requested. Applicant understands that Empire’s reliance upon such information is the basis for the extension of credit. Empire, or its agents, is hereby authorized to obtain and verify any credit information regarding any representations made as to the Company or individuals identified herein, which may include the request of a Credit Bureau Report(s). Applicant hereby agrees to be bound to the above referenced credit terms with respect to any goods, merchandise or services sold to Applicant on credit by Empire. The person signing on behalf of the Applicant hereby states that he or she is authorized and has legal capacity to agree to the within credit terms. The transmission of this credit application as an "electronic record" containing any "electronic signatures" as those terms are defined in applicable federal and/or state laws, of the facsimile transmission of this credit application containing a facsimile of any signature, shall be effective, enforceable and valid as if a paper version of this credit application were delivered containing the original written signature. Execution of this credit application grants Empire permission to contact the applicant, or any individuals identified hereon, by telephone, fax, e-mail or regular mail.

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