Please fill in all blanks completely and sign the agreement before returning it. Please note that it may take up to 2 weeks
for the application to be fully processed, and during the interim any new orders will have to be invoiced either via C.O.D.
or credit card unless otherwise specified by prior authorization.
Thank you for submitting this credit application.
RESPONSIBLE PARTIES
DATE:
Business Name:
Business Address:
City / State:
Date Business Started:
Phone #
Fax #
Soc Sec #
Resale #
Zip:
Partners
BANK REFERENCES
Bank Name
Address:
City/State/Zip:
Account #
Phone #
Fax #
CREDIT REFERENCES
Company:
Address:
City/State/Zip:
Account #
Phone #
Fax #
Company:
Address:
City/State/Zip:
Account #
Phone #
Fax #
Company:
Address:
City/State/Zip:
Account #
Phone #
Fax #
Broker/Salesperson
Credit Terms: Accepted _______ Denied _____
Authorized By:
Corp
Indiv.
FOR OFFICE USE ONLY
Territory Code
Approved Credit Limit:
Date:
Customer verifies that the above information is true and correct and hereby grants permission for any person to furnish
Nordic Naturals, Incorporated information, which, may periodically be requested. In addition, customer authorizes Nordic
Naturals, Incorporated to make any and all inquiries necessary to process the Credit Application, including pulling credit
reports on all responsible parties.
Customer agrees to honor all terms and conditions of the most current price list, and assumes all responsibility for
attainment of said information. Customer agrees to pay for all deliveries under and pursuant to its accounts, whether
ordered by the customer or by any person representing himself/herself/itself to be an agent, employee or representative of
the customer. Credit terms are at the discretion of the creditor who may terminate, alter or deny credit terms without
notice. All sales on credit are net 30 days from date of invoice, unless otherwise specified on invoice. All past due
accounts accrue interest at 2% per month on the declining unpaid balance, or at the legal interest rate, whichever is less.
The accrual of payments of interest does not authorize the customer to defer payment of any indebtedness beyond credit
terms stated herein. In the event of delinquency of any account, customer agrees to pay all collection costs, attorney’s
fees, and court costs in collection of said account, regardless of whether judicial action is undertaken. In the event a
check is returned for any reason there will be a $20.00 service fee incurred.
Signature
Title
Date
94 Hangar Way • Watsonville • CA • 95076 • Phone: 800-662-2544 • Fax: 831-724-6600