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SANTIES WHOLESALE OIL CO, INC.
APPLICATION FOR BUSINESS CREDIT
126 LARCEL DR, P.O. BOX 1108, SIKESTON MO 63801, 573-471-4541, FAX: 573-481-0325
Name Mailing Address
DBA or Trade Name City
Physical Address State, Zip
City Contact for Accounts Payable/Phone #, extension
State, Zip Local Contact Person
Phone                      Fax Local Phone, Fax, Beeper, Cell #
Type of Business Years Established Federal Tax ID #
Type of Organization: Sole Proprietorship Partnership Corporation
State Incorporated
Year
Owner's or President's Name Address
City, State, Zip Phone Soc. Sec. #
Other Officers or Partners:
Bank Reference1:
 
Name
street
city
state
phone
contact person
Account Numbers/Types
Bank Reference2:
 
Name
street
city
state
phone
contact person
Account Numbers/Types
Trade References: (minimum of 2)
1.
Name
street
city
state
phone
contact person
2.
Name
street
city
state
phone
contact person
Dunn & Bradstreet Rating?   Yes     No   If yes, Dun & Bradstreet #
Billing Question:
Are PO #'s required for any or all purchases? Yes     Please describe.
Will purchases be sales tax exempt?  If so, PLEASE INCLUDE EXEMPT FORM WITH CREDIT APPLICATION.
TERMS AND CONDITIONS
  1. We hereby authorize the listed companies and/or banks to release any information requested of them necessary to establish a line of credit with Santie Oil Company.
  2. All delivery invoices are subject to error and price correction. If such error occurs, purchaser will be mailed a correced copy and shall use corrected amount for payment.
  3. From time to tme, Santie Oil Company may place equipment at or for the use of applicant, at such time an equipment agreement will be executed.
  4. It is understood and agreed by applicant that, if this application is approved and credit extended to applicant, the terms of such credit account will be:
    (see line checked)

 Net due 30 days from date of delivery. (Lubricants & Related)

 Net due 10th of the following month. (All Fuels)

Applicant agrees to pay a service charge of 2% per month, which will be added to any account not paid within terms. In the event of and default, applicant agrees to pay all cost of collection, including reasonable attorney's fees or third party collector, if incurred. Applicant agrees that any despute of the terms of this agreement including default will be settled in Scott County Missouri.
Signature of Applicant or authorized agent
Title
Date
Signature of Co-Applicant or Partner
Title
Date
Signature of Co-Applicant or Partner
Title
Date