Confirmation of Information
Accuracy and Release of Authority to Verify.
The undersigned, for the procuring and
establishing credit from time to time with Supplier to permit the
above named customer to become indebted to Supplier for purchase of
goods, materials, and/or services, furnishes the above business and
personal credit information. The undersigned, jointly and individually,
certify that all information in this Credit Application is complete,
factual and correct, and understands the Supplier will rely on the
accuracy of this information for any credit that may be extended.
Supplier is hereby expressly authorized to contact any parties listed
herein and to verify any information contained in this Credit Application.
The undersigned hereby waives any privacy of credit information rights
or regulations. If any representations made on the Application
prove to be untrue, the undersigned agrees that all obligations of
the above named customer to, or held by, Supplier shall immediately
become due and fully payable without demand or notice, and the undersigned
further expressly agrees to assume personal liability for all obligations
of said customer to Supplier. The undersigned hereby acknowledges
receipt of a copy of this Credit Application.
