Application for Credit and Trade Recognition


Please complete ALL of the following information in order to
expedite the opening of your account.

Anchor Distributors sells at trade discounts to retail stores and approved wholesalers.  We do not sell at trade discounts to churches, study groups, agents, book tables, or non-trade organizations.  The following qualifies as a trade account:

  1. Open at least 6 hours a day for 5 days a week
  2. An entrance door that gives direct access to the store
  3. Stock on display for immediate purchase by customer
  4. Open to the general public

 

  1. Operated with proper business Licenses
  2. A sign on the exterior
  3. Operated in a commercially approved zone

Application Instructions

  • Please complete as much of the information as possible to expedite the opening of your account.
  • Fields marked with an * are required.
  • Date fields should be in the format of mm/dd/yyyy.  For example: June 20, 1996, should be entered as 6/20/1996.
  • You must check both "I AGREE" boxes at the end of the application to indicate that you will adhere to the terms as shown.


 
General Information:


Bill to Store Name *
Address Line 1
*
Address Line 2
 
City
*
State
 Zip Country
Phone Number

Fax Number
E-mail
Days and Hours open per Week

Ship to Store Name
Address Line 1
Address Line 2
City  
State
 Zip  Country
Phone Number
Fax Number

Date Store Established *
Membership  CBA  ABA
Membership Number

Date Membership Established


Business Information:

Type of Ownership  Corporation  Partnership  LLC  Church Owned  Sole Proprietorship

Description of Business:

Does business have a prominent sign outside?
    Yes   No  (A picture may be needed in some cases)

 Bookstore in Main Business District/Shopping Center   
 Book Department of Retail Store Property  Own   Rent
         What type of store    Monthly Payment: $
 College Store    Square Footage: sq ft
 Bookstore in Church Number of Employees
 Internet Store   Web Site    Full-Time
 Mail Order (Please send a copy of your catalog.)    Part-Time
 Showroom at Home
 Other:

Sales Tax ID number (Please fax a copy.): 

On which basis do  Prepay with Check/Credit Card  COD
you prefer to purchase   Open Account  $

Has the firm or any of its principals ever been bankrupt?   Yes   No
   If yes, please explain

For Established Businesses:

Sales Last Year  $ Sales 2 Years Ago  $ Cash on Hand  $

For New Businesses:

Amount of Cash available to be devoted to your business  $   Projected Sales  $


Proprietor, Partners, or Corporate Officers (Please provide your home address):

Name   Street  
Title     City  
State    Zip    Country
Social Security #   Home Phone  
Name   Street  
Title   City  
 State    Zip    Country
Social Security #   Home Phone  
Name   Street  
Title   City  
 State    Zip    Country
Social Security #   Home Phone  


Trade Credit References:

Business   Account #   Date Opened  
Credit Line  $ Account Balance  $ Phone  
Business   Account #   Date Opened  
Credit Line  $ Account Balance  $ Phone  
Business   Account #   Date Opened  
Credit Line  $ Account Balance  $ Phone  


Banking Information:

Bank Name  
Address Line 1  
Address Line 2  
City     State     Zip Code    Country
Bank Phone Number  
Exact Name under which account is listed  
Account Number     (Please check one.)  Savings   Checking


Please read and acknowledge below the agreement to terms and conditions of sale:

The extension of credit for all orders is subject to credit approval.  Anchor Distributors retains the right to withhold orders on delinquent accounts.  Authority is hereby given to bank and trade references allowing the release of credit history on this business to Anchor Distributors.  A 1.5% service charge, (18% per annum), or the rate legally allowed by the law will be assessed to past due balances.  Dishonored checks, including bank fees, must be paid in full according to the table of bad check laws that governs the debtor's jurisdiction.  The debtor is responsible for all costs incurred by Anchor Distributors for securing bad debts, i.e., collection agencies, court costs, and attorney fees.

I acknowledge and agree to abide by the above terms and conditions of sale for the extension of credit.  All answers are true and correct to the best of my knowledge.  By selecting "I Agree" below, I attest to our financial solvency, ability, and willingness to pay all obligations as they come due.

 I AGREE *

Personal Guarantee:

In the event this account becomes delinquent and satisfactory arrangements have not been made for payment, all collection costs and attorney fees will be assumed by the debtor.  By applying for credit, being accepted and selecting "I agree" on this application, I agree to the above terms and conditions of sale.  I assume personal responsibility for payment to Anchor Distributors.  This guarantee and every part thereof shall extend to and be obligatory to my heirs, executors, administrators, and assigns and shall insure to the benefit of Anchor Distributors and their successors and assigns.

 I AGREE *