CREDIT APPLICATION / SOLICITUD DE CRÉDITO

Transcripción

1 CREDIT APPLICATION / SOLICITUD DE CRÉDITO Unisol International Corp. COMPANY INFORMATION / INFORMACIÓN DE LA EMPRESA Legal Business Name / Nombre Legal de la Empresa Account Number / No. de Cuenta con Unisol City / Ciudad State / Estado Zip Code / Código Postal Country / País Phone / Teléfono Fax Number of Employees / No. de Empleados Year Establshed / Año Fundada Website / Sitio Web Annual Sales Revenue / Ventas Anuales (USD) Dun & Bradstreet (D&B) Number Federal Tax ID / RFC / NIT / RUT Requested Credit Line Amount / Línea de Crédito Solicitada (USD) Requested Payment Terms (Place an X )/ Términos de Pago (Marque una X ) $1-5K $5-10K $10-25K $25-50K +$50K 20 Days / 20 Dias 30 Days / 30 dias BUSINESS PRINCIPALS / PRINCIPALES CONTACTOS 1. Name / Nombre Position / Puesto Telephone / Teléfono Fax Soc. Sec. # / No. ID Personal / Pasaporte / ID Oficial Drivers License No. and Issuing State (USA Only) 2. Name / Nombre Position / Puesto Telephone / Teléfono Fax Soc. Sec. # / No de Seguro Social / Pasaporte / ID Oficial Drivers License # and Issuing State (USA Only) 3. Name / Nombre Position / Puesto Telephone / Teléfono Fax Soc. Sec. # / No de Seguro Social / Pasaporte / ID Oficial Drivers License No. and Issuing State (USA Only) Contact Person / Persona Contacto ACCOUNTS PAYABLE CONTACT / CONTACTO DE CUENTAS POR PAGAR Telephone / Teléfono Fax 1

2 BANK CREDIT REFERENCE / REFERENCIA DE CRÉDITO BANCARIA 1. Bank Name / Nombre del Banco BANK INFORMATION / INFORMACIÓN BANCARIA Contact Person / Persona Contacto Account Number / No. de Cuenta Account Type / Tipo de Cuenta Telephone / Teléfono Fax Dear Bank Officer: I authorize you to release credit information about my account standing, credit line, and history to Unisol International Corp. to be used explicitly for the establishment of an open account and credit line. This information is to be kept with strict confidence. This page may be reproduced or photocopied and a faxed copy shall be as effective consent as the original which I have signed. Signature / Firma: Name / Nombre: Company / Empresa: City / Ciudad: Phone / Teléfono: Date / Fecha: Title / Cargo: : State, Zip / Estado, Código Postal: Country / País: DO NOT WRITE BELOW THIS LINE, FOR BANK USE ONLY To whom it may concern: The above referenced customer has given your bank as a reference to obtain credit. Please supply us with the following information and return to us via fax ( ) at your earliest convenience. The information will be kept secure and confidential. ACCOUNT INFORMATION / INFORMACIÓN DE LA CUENTA Account Type Date Opened Average 3 Month Account Balance Non-sufficient Funds (NSF)? If YES, Number of Times Yes No Line of Credit? Date Established Payment Habit Yes No Amount Owed Secured By Comments Officer Name Title 2

3 TRADE REFERENCES / REFERENCIAS COMERCIALES MUST PROVIDE AT LEAST 3 REFERENCES / DEBE PROVEER AL MENOS 3 REFERENCIAS Unisol International Corp. (The more references you provide, the faster we can process.) (Entre más referencias, más rápido se procesará.) DOMESTIC TRADE REFERENCES / REFERENCIAS COMERCIALES DENTRO DE EUA 1. Company Name / Nombre de la Empresa Contact Person / Persona Contacto 2. Company Name / Nombre de la Empresa Contact Person / Persona Contacto 3. Company Name / Nombre de la Empresa Contact Person / Persona Contacto INTERNATIONAL TRADE REFERENCES / REFERENCIAS COMERCIALES INTERNACIONALES 1. Company Name / Nombre de la Empresa Contact Person / Persona Contacto Country / País 2. Company Name / Nombre de la Empresa Contact Person / Persona Contacto Country / País 3. Company Name / Nombre de la Empresa Contact Person / Persona Contacto Country / País 3

4 GENERAL TERMS AND CONDITIONS / TERMINOS Y CONDICIONES GENERALES 1. The undersigned certifies that the information provided herein is correct and that it is submitted for the purpose of obtaining Credit and authorizes Unisol International Corp. (Seller) to investigate the references provided and further authorizes the above stated references to release all financial information requested to Unisol International Corp. The undersigned understands that Unisol International Corp. is relying on the information provided in making the decision to extend credit. 2. All goods and services received by the Buyer shall be considered accepted by the Buyer at the time of receipt. Any and all discrepancies must be noted at the time of receipt. 3. The Buyer agrees to pay the Seller for goods and services according to the seller s terms. 4. Buyer understands and agrees to pay all charges in accordance with its approved credit terms (If credit terms have not been established then COD or credit card payments will apply). Buyer understands that a two percent (2%) Finance Charge per month (Annual percentage rate of 24%) will be added to Buyer s account at the end of each month for balances 30 days or more past due and Buyer agrees to pay said charges. 5. Should it become necessary to place this account for collection, suit or other legal proceedings, the undersigned agrees to pay all costs and expenses of collection, suit or other legal action, including a reasonable attorney s fee and, if necessary, appellate fee. Venue shall be Miami-Dade County, Florida, United States of America. I hereby certify that the information in this credit application is correct. The information included in this credit application is for use by Unisol International Corp. in determining the amount and conditions of credit to be extended. I understand that Unisol International Corp. may also utilize the other sources of credit which it considers necessary in making this determination. Further I hereby authorize the banks and trade references listed in this credit application to release the information necessary to assist Unisol International Corp. in establishing a line of credit. Name: Date: Title: Signature of Business Principal: PERSONAL GUARANTEE / GARANTÍA PERSONAL (Only for those companies requesting credit lines equal to or greater than USD $25,000.) (Solamente para aquellas empresas que soliciten líneas de crédito igual o superior a USD $ ) In consideration to the extension of credit by the Seller, herein to Buyer herein, the undersigned does jointly and severally personally guaranty to pay and be responsible for payment of all sums, balances and accounts due Seller by Buyer, including collection charges and/or attorney s fees. This shall be open and continuing guaranty and shall continue in force notwithstanding any change in the form of such indebtedness, or renewals or extensions granted by Seller, without obtaining any consent thereto, and until expressly revoked by written notice from me/us to Seller. Any such revocation shall not in any manner affect my/our liability as to any statute, against the Buyer. No delay on Seller s part in exercising any right hereunder, or taking any action to collect or enforce payment of any obligation hereby guaranteed, either as against the Buyer or any other person primarily or secondarily liable with the Buyer, shall operate as a waiver of any such right or in a manner prejudiced Seller s rights against me/us. I/we agree that in the event of any default at any time by said Buyer, Seller shall be entitled to look to me/us immediately for full payment without demand or notice. Name: Date: Title: Signature of Business Principal: 4

5 ADDITIONAL DOCUMENTS REQUIRED / DOCUMENTOS ADICIONALES REQUERIDOS Documents must be received complete; otherwise the application will not be processed. Los documentos deben recibirse completos, de lo contrario la aplicación no podrá ser procesada. 1. Audited Financial Statements for last 2 years. Estados Financieros Auditados de los últimos 2 años. 2. Copy of business verification documents (See list on following page). Copia de documentos (Ver listado en próxima pagina.) 3. Business Principal(s) valid ID Identificación oficial de los principales contactos Latest Bank Account Statements (International accounts only). Últimos 3 estados de cuenta bancarios (Cuentas Internacionales solamente) Commercial Reference Letters and/or Credit Letters. 2 Cartas de Referencias Comerciales de Principales Proveedores. Please send completed application and documents via FAX (305) or credit@unisolinternational.com Processing time is approximately 8-10 business days. Por favor enviar aplicación completada y documentos vía FAX (305) o credit@unisolinternational.com Tiempo de procesamiento es de aproximadamente 8-10 días hábiles. DO NOT WRITE BELOW THIS LINE FOR USE BY UNISOL INTERNATIONAL CORP. ONLY Date Authorized by Client # Terms Given Credit Limit Approved/Denied Purchases YTD Sales Rep Comments: 5

6 PLEASE ATTACH THE DOCUMENTS CORRESPONDING TO YOUR COUNTRY POR FAVOR INCLUYA LOS DOCUMENTOS CORRESPONDIENTES A SU PAÍS ARUBA HAITI ARGENTINA Numero de Inscripción de la Sociedad C.U.I.T. Clave Unica de Identificación Tributaria HONDURAS RTN (Registro Tributario Nacional) ANTIGUA JAMAICA BARBADOS MEXICO Alta ante Hacienda (R-1) Registro Federal de Contribuyentes (RFC) Acta Constitutiva Comprobante de Domicilio Identificación oficial de representante legal BERMUDA NICARAGUA Constancia de Responsable BAHAMAS PERU Licencia Municipal de Funcionamiento Registro de Comercio o Patente Comercial BONAIRE PARAGUAY RUC (Registro Único de Contribuyentes BOLIVIA Certificado de Cámara y Comercio N I T (Numero de Identificación Tributaria) PANAMA Pacto Social BRAZIL CGC (Cadastro Geral de Contribuinte) PUERTO RICO Patente de Comercio BELIZE ST. KITTS CHILE Inscripción Registro de Comercio SII (Servicio Impuestos Internos) ST. LUCIA RUT (Roll Único Tributario) CAYMAN ISLANDS ST. MAARTEN Certificado de Cámara y Comercio COLOMBIA NIT (Numero de Identificación Tributaria) SURINAM CANADA ST. VINCENT Personeria Juridica COSTA RICA RUC (Cedula Jurídica) TURKS & CAICOS CURACAO TRINIDAD & TOBAGO DOMINICA URUGUAY Contrato Social y Publicaciones Legales Actas de Asamblea y Directorio Copia de documentos constitutivos REPUBLICA DOMINICANA RNC (Registro Nacional de Contribuyente) UNITED STATES Tax Exemption Certificate ECUADOR EL SALVADOR GRENADA GUATEMALA GUYANA Certificado de Registro Mercantil Resolución de la Superintendencia de Compañías RUC (Numero de Registro Único de Contribuyentes). NIT (Numero de Identificación Tributaria) IVA (Numero de Registro de Impuestos Internos) Registro General Mercantil NIT (Numero de Identificación de Contribuyentes) VENEZUELA VIRGIN ISLANDS Registro Mercantil RIF (Registro de Información Fiscal) 6