Charge account application - Nassco Limited



Individual Charge Account Application

|Personal Information |

|Name (First, Middle, Surname): |

|Home Address: |

| |

|Country: |Zip Code: |

|Email: |ID No.: |

|Phone No.: |Cell Phone No.: |

|Employment History | |

|Employer: |

|Address: |

| |Zip Code: |

|Job Title: |Salary: |

|Phone No.: |No. Of Years With Company: |

|Vehicle History |

|Vehicle Registration No: |Model: |

|Vehicle Registration No: |Model: |

|Vehicle Registration No: |Model: |

|Financial Reference |

|Bank/Credit Union: |

|Address: |

|Phone No.: |Account No.: |

| |

|Commercial Reference |

|Company Name: |

|Address: |

|Phone No.: |Account No.: |

I hereby certify that the information contained herein is complete and accurate. This information has been furnished with the understanding that it is to be used to determine the amount and conditions of the credit extended. Furthermore, I hereby authorize the financial and commercial institutions listed in this credit application to release necessary information to the company for which credit is being applied for, in order to verify the information contained herein.

|Signature: |Date: |

|Print Name: | |

|NASSCO Credit Terms and Conditions |

NASSCO Ltd is pleased to extend charge account privileges to any qualified customer desiring this facility under the following conditions:

By submitting this application, the undersigned purchaser agrees to pay for all invoices on which credit was extended per our terms of Net 30 days. On the last business day of each month a statement will be prepared and mailed to you listing all unpaid invoices as of the close of business for that month. The amount shown as current on the statement is due by the 30th of the month following the statement date. Those amounts that are recorded under 30, 60, 90 and 120 days will be considered past due and will attract a service charge of 1.5% per month.

Statements of account will be rendered monthly and any discrepancies must be reported to NASSCO Ltd. within 30 days after the statement date. If no discrepancies are reported within this period, NASSCO Ltd will conclude that the applicant is in agreement with the statement.

Your account will be assigned a credit limit that is subject to review at any time. Should your account become past due, NASSCO Ltd. reserves the right to discontinue charge facilities and initiate a Cash on Delivery basis until such time as your balance is returned to current status. NASSCO Ltd. reserves the right to terminate any account that is not settled in full within the specified period.

The undersigned purchaser agrees that he will pay any legal fees and third party (e.g., bailiff) collection costs incurred in recovering an unpaid balance.

The undersigned purchaser asserts that the information contained herein is accurate and may be relied upon in making credit decisions.

The undersigned purchaser authorizes the financial and commercial institutions listed in the credit application to furnish NASSCO Ltd with any information necessary to complete its credit evaluation. NASSCO Ltd is further authorised to disclose to any credit bureau, reporting agency, business or person, such information regarding my credit history as is appropriate and lawful in the circumstances. The applicant agrees to indemnify and save NASSCO Ltd harmless from any and all claims in damages or otherwise arising from any disclosure.

I HAVE READ THE TERMS OF THIS AGREEMENT AND AGREE TO BE BOUND BY THEM IN ALL RESPECTS.

This__________day of__________________, 20_____.

Signature: _____________________________________

Print Name:_____________________________________

|INTERNAL USE ONLY |

|Account No: |Credit Limit: $ |Date: |

|Reviewed By: |Approved By: |Denied By: |

All charge account applications must be accompanied by a copy of your Barbados identification card or passport, a current job letter, a recent pay slip, and some other form of documentation (e.g., Driver’s Licence) to provide proof of address.

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