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Application for Credit

  • Statement
  • Part 1
  • Part 2
  • Part 3
  • Part 4

Dear Customer,

Dear Customer: When completing the attached credit application, it is very important that all information requested is filled out in full. All of the information we request is very imporant and helpful in processing your application. If the application is turned in with incomplete information, it will delay processing by several days. If too much information is left off, we will have to return the application to you to be completed properly. Once an account has been opened we must have a legible copy of your EPA, A/C, and drivers license on file before we can release any merchandise. We appreciate your business and will do our best to process your credit application as quickly as possible. Please help us out by completing everything in full. Normally processing time is about 4 to 7 business days. Thank you, Credit Department AACA Parts and Supplies 3227 Military Parkway Mesquite, TX 75149 Phone (972) 289-5344 Fax (972) 289-0760

General Information

What branch will you be purchasing from the most?

Business Info

Business Name

Physical Address

City

State

Zip

Mailing Address (If different from above)

City

State

Zip

Phone Number

Fax Number

Email Address

Years in Business

Annual Sales

Approximate Net Worth

Type of Business

Estimated Monthly Purchases

Check One

Principles of Business

Owner(s) President

SS#

TDL#

Home Address

Home Phone

Vice President

SS#

TDL#

Home Address

Home Phone

Company Contact for Billing Inquiries

Phone Number

Special billing instructions/information?

Tax Exempt?

Sales Tax #

PO Requited?

Person authorized to charge

Misc. Information

Credit Account References

All information must be completed in full to be considered for Credit.

Vendor Name

Phone #

Fax #

Account #

Vendor Name

Phone #

Fax #

Account #

Vendor Name

Phone #

Fax #

Account #

Banking Relations

Bank Name

Phone Number

Contact Person

Checking Account #

Savings Account #

Bank Loans?

Loan #

Terms of Sale

The net amount charged is due 30 days from the date of invoice and all payments are past due after that date. Interest will be charged on all past due accounts at a rate as stated in this agreement. ALL BILLS WILL BE PAID IN ACCORDANCE WITH OUR TERMS, REGARDLESS OF WHERE, WHEN OR HOW THE MATERIAL PURCHASED FROM US MAY BE USED. Merchandise returned is subject to a 10% restocking fee. Any damaged, mutilated, altered or otherwise unsellable merchandise cannot be returned. All sales are made and all accounts due are payable at Mesquite, Dallas County, Texas. In the event collection is made through an agency or attorney, reasonable attorney's fee and all other costs of collection shall be paid by the Applicant/Debtor. All accounts are subject to the credit limits set by our credit department. In the event purchaser defaults in making payment for any purchases made pursuant hereto, or fails to comply with any of the terms and conditions of the invoices on which same shall be purchased, or if a proceeding in bankruptcy, receivership or insolvency be instituted by or against the purchaser of his property, the seller shall have the right, at it's election, with or without notice or demand, to declare the entire account of Purchaser to be immediately due and payable. Purchaser grants Seller a security interest in all goods purchased under this agreement.

Applicant hereby verifies that he has read the foregoing terms of sale and Applicant hereby agrees to abide by the policies stated above in order to induce AACA Parts and Supplies to do business with and extend credit to Applicant. As a further inducement to AACA to do business with Applicant on an open account basis, Applicant hereby contracts and agrees to pay AACA on all accounts past due, interest at the highest rate allowed by law, to be a minimum of ten (10%) percent per annum, provided, however, that if Applicant is a corporation, Applicant agrees to pay AACA interest in the amount of eighteen (18%) percent per annum on all accounts wherein the amount of credit extended or anticipated to be extended over the terms of the parties business relationship, or any renewals or extensions of said credit, are expected to exceed in the aggregate sum of $5,000.00 or more. In consideration for AACA Parts & Supplies extending credit to the business identified below for any material and/or services after this date at the request of applicants or its agents, the undersigned individual hereby personally guarantees unconditionally and irrevocably the prompt payment of any sums now or hereafter owed to AACA Parts & Supplies by the business identified below whether said sums are due under open account, contract or otherwise. It is understood and agreed that credit, if extended, is to be on a continuing basis and may exceed estimated maximum credit limit requires as stated in the credit agreement between AACA Parts & Supplies and the business. AACA Parts & Supplies shall not be obligated to notify the undersigned of the dates or amounts of any such credit and the undersigned waives demand, notice of default and any extension of time or any other forbearance which may be extended by AACA Parts & Supplies. This guaranty shall continue in force until in writing, sent by registered or certified mail, return receipt requested by AACA Parts & Supplies. Said notice shall specify the date on which this guaranty is to be terminated, said date not to be less than seven days after such notice is received. Such termination shall in o way release the undersigned as to any sum or debt incurred prior to such termination.

Date

Name (Name of person guaranteeing payment, NO TITLE)

Home Address

Home Phone #

SS#

Name of person guaranteeing payment (This will serve as your electronic signature)

Name of Business whose account is guaranteed

Please download, sign, and return the following authorization for for AACA Parts & Supplies to investigate your credit record and/or banking relations. Authorization Form

Billing Preference

Name

Address

City, State, Zip Code

Billing Contact

Billing Phone Number

PLEASE CHOOSE ONE METHOD FOR RECEIVING (OR NOT RECEIVING IF YOU PREFER) INVOICES AND ONE METHOD FOR RECEIVING STATEMENTS.

Please FAX all our invoices to this fax number:

Fax Number

Please EMAIL all our invoices to this email address:

Email Address

Please FAX our monthly statement to this fax number:

Fax Number

Please EMAIL our monthly statement to this email address:

Email Address

Select all that apply

Important Notice

Dear valued customer: PLEASE NOTE: Procedure from 10-1-15 letter to be implemented IMMEDIATELY. Due to an increased expense associated with the processing of credit card payments and the new guidelines from the PCI (Payment Card Industry), AACA Parts & Supplies finds it necessary to modify payment methods accepted from our customers. If you have a balance on an open account with AACA and are paying on your account, we respectfully request you send payment (via U.S. Mail or in person) by cash, check, money order or cashier's check to pay toward your account balance. If you are paying existing charges on an account by credit card, the card must be presented at any of our locations. We will also be implementing a convenience fee of 2% of the account balance paid with the credit card. Example: Credit card payment on account - $100.00 Amount of transaction on credit card - $102.00 ** For your record-keeping we will generate an invoice for the convenience fee. We have recently purchased credit card terminals that are able to read the "chip" features in newer cards. For your safety we highly recommend you make sure your bank has furnished you with a chipped card. These measures are being implemented to help bring us into compliance with the security guidelines implemented by PCI regulations and standards effective October 1, 2015. They will serve as a protection from possible fraud for our customers and for AACA Parts & Supplies. As always, we appreciate your business and welcome any questions you may have concerning this matter. Best regards, Sharon Waldrep Accounts Receivable

Required Documents

Please upload the following required documents: EPA license Air Conditioning License (T.A.C.L.) Picture I.D. (Driver's License) Signed authorization form