Credit Application

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Automated Office Solutions Credit Application

Business Trade Name (DBA)

_____________________________________________________________________________________

Business Legal Name (as it appears on business license)

__________________________________________________________________________________________________________

Business Address (City, State, Zip)

__________________________________________________________________________________________________________

Phone Number _____________________________________________________________________________________________

Fax Number ______________________________________________________________________________________________

Email Address ____________________________________________________________________________________________

Controller: _______________________________________________________________________________________________

Accounts Payable Contact: __________________________________________________________________________________

Credit Manager: ___________________________________________________________________________________________

This company is a (check one) _____ Sole Proprietorship _____ Partnership _____ Corporation

If incorporated, in what state? ____________________________________________________________________________

Length of time in business _______________________________________________________________________________

Length of time at this location ____________________________________________________________________________

Is the billing address the same as your business address? __________ If not, give details.

__________________________________________________________________________________________________________

__________________________________________________________________________________________________________

__________________________________________________________________________________________________________

__________________________________________________________________________________________________________

Bank Name _______________________________________________________________________________________________

Address _______________________________________________________________________________________________

City, State, Zip _____________________________________________________________________________________________

Account Officer ____________________________________________________________________________________________

Telephone ________________________________________________________________________________________________

Checking Account Number ___________________________________________________________________________________

AGREEMENT AND DISCLOSURE

This credit application and agreement is submitted by customer to Automated Office Solutions, Inc. to obtain credit. Customer agrees to make payment in full to Automated Office Solutions, Inc. for all amounts due according to Automated Office Solutions, Inc. invoice's). Customer also agrees to pay Automated Office Solutions, Inc. any interest, an amount equal to 1.5% per month or the maximum allowed by law, whichever is less, for invoice amounts that are past due should the customer default in any such payment's). Automated Office Solutions, Inc. shall have the right, without notice to customer, to declare all invoice amounts due and payable in the event Automated Office Solutions, Inc. should commence any action or actions or otherwise act to enforce this agreement against customer agrees to pay reasonable attorney's) fees, court costs and other expenses incurred by Automated Office Solutions, Inc. whether or not suite is filed. The agreement is strictly confidential and is not transferable or assignable without the prior written consent of Automated Office Solutions, Inc. Customer agrees that any change in liability for any debt incurred to Automated Office Solutions, Inc. due to a change in customers form of business, shall not be effective as to Automated Office Solutions, Inc., until Automated Office Solutions, Inc. receives actual notice of the change by certified mail.

By signing this agreement, I/we authorize the release of credit and banking information to Automated Office Solutions, Inc. by the reference listed above.

Signed as of this the ______________ day of _________________________________, 20_______.

Owner/Officer Signature ___________________________________________________________________________________

Print Name and Title ______________________________________________________________________________

When completed fax to (678)916-0440