Credit Form

Applicant

Company Name

Billing Address

City

State

Zip

Physical Address

City

State

Zip

Is this location the Corporate Office?

Branch?

Corporate Address

Company Phone #

Company Fax #

Accts. Payable Contact Name

AP Contact Phone #

AP Contact Email

Years in Business

Ownership

Corporation

Check here if incorporated in the past 12 months

Partnership

Individual

Names of Principals

Complete Address

Title

Phone

Names of Principals

Complete Address

Title

Phone

Names of Principals

Complete Address

Title

Phone

Finance

Bank

Complete Address

Phone

Reference

Business Name

Complete Address

Phone

Business Name

Complete Address

Phone

Business Name

Complete Address

Phone

Business Name

Complete Address

Phone

Terms

NET 30 DAYS UNLESS OTHERWISE STATED ON INVOICE OR AGREED IN WRITING. PURCHASE ORDER LANGUAGE SHALL NOT

INVALIDATE STANDARD TERMS. ANY DEVIATION FROM STANDARD TERMS MUST BE AGREED PRIOR TO ORDER PLACEMENT.

If the account is not paid within the above terms, a service charge of 1.5% will be charged each month and thereafter on all past due amounts until paid.

ACCOUNTS PAST DUE BY MORE THAN 15 DAYS WILL BE REVIEWED FOR HOLD STATUS UNTIL BROUGHT CURRENT.

In the event that it becomes necessary to assign this account for collection to an attorney or collection service, the undersigned applicant agrees

to pay all collection costs and reasonable attorney fees that are incurred. This agreement will be construed under the laws of the State of Washington.

The applicant further agrees that venue of any suit will be held in King County, WA.

The undersigned applicant agrees that all invoices and monthly statements are conclusive and accurate in all respects

unless the undersigned notifies Spinfinity, within 10 days of receipt of the invoices or statement.

The applicant (a) certifies that all the information on this form is complete and correct, (b) agrees that all credit terms are understood and accepted, (c) agrees that timely payment of invoices is a condition for the extension of credit and delivery of goods, (d) certifies that the person signing this document has authority to sign on behalf of applicant and to contractually bind applicant, and (e) that the typed name or electronic signature of the signer shall be deemed to be an original signature on behalf of applicant.

Date

(Signed)

(Title)

Office Use