Business Physical Address Net 30 Charge Account Application 815 W. University Drive, Suite 101 Tempe, AZ 85281 p 480/968/7821 f 480/968/8765 www.us004.alphagraphics.com Tax ID#: 86-0846888 Name of Business Street Address City Phone State Zip Fax Product or Service you offer Amount of Credit you desire per month Business Classification Sole Proprietorship Corporation Partnership Company Owner's Name Title Phone 8 If credit is granted (I) (we) promise to pay bills when rendered. (I) (We) understand all invoices are payable within 30 days and that a service charge of 1 1/2 % per month will be added to (my) (our) past due account. in the event payment is not made and (my) (our) account is referred to a collection agency, (I) (we) will pay all costs of collection. If legal action is required (I) (we) will pay reasonable attorney's fees resulting from such action. (I) (We) authorize the above listed bank(s) and trade references to release to AlphaGraphics any credit or financial information that AlphaGraphics may request and further agree if AlphaGraphics grants credit to comply with the above terms of credit. The following persons are authorized to sign for charges: Name Title Signature Date Rev. 08/05 Billing Address Name of Business Street Address City Phone State Zip Fax Billing Contact Person e-mail address Are Purchase Orders Required? Yes No Tax Exempt # (if applicable) Please fax a copy of tax certificate to 480.968.8765 (required) (required) Name Address City State Zip Phone Fax Account # for office use Name Address City State Zip Phone Fax Account # for office use Name Address City State Zip Phone Fax Account # for office use • • • Please list 3 creditors whom you have verifiable lines of credit. Please include account numbers if needed to verify information. You may submit a prepared list of references that contain the required information. STEP ONE : COMPANY INFORMATION STEP TWO: : CREDIT REFERENCES STEP THREE: : COMPLETION *Please allow 3 business days for processing completed applications Sign and fax this and other applicable documents to 480.968.8765