Credit - Vitality 4 Life

Business Credit Application For Net 30 Day Terms

Please allow 24-48 hours for approval.

Company Name*

Billing Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Shipping Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Name*

First Last

Email Address*

Phone Number*

Taxpayer Identification Number (EIN)*

D & B #*

Purchasing Contact*

Years in Business*

Bank Referance

Bank Name*

Address*

Account Number*

Phone Number*

Agreement

I certify that the information herein is true and correct. I fully understand that Vitality Enterprises’ terms are strictly Net 30 Days. I agree to abide by the following terms: I agree to pay invoices within 30 days of receipt. An interest charge in the amount of 1.5% will be added to all accounts that exceed 30 days. I agree to pay all reasonable collection and attorney fees, if needed, to collect late payments. No refunds will be given for over payment. A credit will remain on your account and can be used for future purchases.

Terms and Conditions*

I agree to comply to terms.
I am authorized to enter into the terms and conditions of this Agreement.

Signature*

By typing my name above, I am electronically signing this application

Date*

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