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Email to: Receivables@GraphicHouseInc.com <br />CONFIDENTIAL CREDIT APPLICATION <br />Legal name of corporation, partnership or proprietorship________________________________________________________________________________ <br />Address_____________________________________________________________City__________________________State_________Zip____________ <br />Business Phone_______________________________________________________________________________________________________________ <br />If this is a subsidiary: <br />Name and address of parent company______________________________________________________________________________________________ <br />TYPE OF ORGANIZATION: ADDITIONAL INFORMATION: <br />￿ Individual Proprietorship How long in existence: ____________ years <br />￿ Partnership Tax Exempt ￿ Yes ￿ No <br />￿ Corporation: State & Date of Incorporation ____________________________ (If yes, please attach an exemption certificate) <br />￿ Other________________ <br />Principals: Name Home Address Position Phone # <br />A___________________________________________________________________________________________________________________________ <br />B___________________________________________________________________________________________________________________________ <br />C___________________________________________________________________________________________________________________________ <br />AUTHORIZED INDIVIDUALS TO ENTER INTO CONTRACTS ON BEHALF OF THE ORGANIZATION: <br />Name_________________________________________________Title________________________________ Number of Signatures Required: <br />Name_________________________________________________Title________________________________ ￿ One ￿ Two <br />CREDIT REFERENCES: <br />1. Bank Name _______________________________________________ Phone #_________________________ ABA Routing #___________________ <br /> Street Address____________________________________City______________________State________Zip________ Acct. #___________________ <br /> Bank Officer Name _________________________________________ Phone #_________________Email___________________________________ <br />2. Supplier: Name ____________________________________________ Phone #_________________Email__________________________________ <br /> Street Address____________________________________City______________________State________Zip________ Contact __________________ <br />3. Supplier: Name ____________________________________________ Phone #_________________Email__________________________________ <br /> Street Address____________________________________City______________________State________Zip________ Contact __________________ <br />4. Supplier: Name ____________________________________________ Phone #_________________Email__________________________________ <br /> Street Address____________________________________City______________________State________Zip________ Contact __________________ <br />I certify that all of the above information is true and correct to the best of my knowledge. I authorize Graphic House, Incorporated to verify this information <br />and/or obtain additional information from credit reporting agencies to verify or supplement the provided information. I agree to pay attorney fees and court <br />costs should they become necessary for the collection of this account. <br />Printed Name___________________________________________________ <br />Signed for the Organization________________________________________ Position _________________________________Date__________________ <br />PERSONAL GUARANTEE <br />In consideration for the credit extended to the above listed organization, I hereby guarantee and agree to be personally liable for all indebtedness incurred by <br />the organization through any of its agents listed above. <br />Print Name_____________________________________________________ <br />Signed________________________________________________________________________________Date___________________________________ <br />FOR GHI Use: <br />Sales Representative___________________________________________________________________________________________________________ <br />￿ Approved ￿ Denied Remarks____________________________________________________________________________________________ <br />Credit Dept. Authorization________________________________________________________________________________________________________ <br />Page 168 of 637