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Camilla Pecan Company Application for Credit

Answer every question completely. Required questions will be highlighted with red.

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Date:

Name for account: Phone: Address: Street address

City

State

Zip

Federal ID#: Choose one: Name of Parent Comany if Subsidiary: Contact Name: Payable Contact: Type of Buisness or Organization: At Present Location Since: Year Established: Please list one bank reference and two vendor references. List only those companies that sell to you on a charge basis: (BANK) Reference #1: Name

Phone

Address

City

State

Zip

Contact Person

Reference #2: Name

Phone

Address

City

State

Zip

Contact Person

Reference #3: Name

Phone

Address

City

State

Zip

Contact Person

If your group does not have a bank account, we require the following information on the individual who will be responsible for payment of charges incurred.: Name

Social Security

Bank Name

City

State

Zip

Bank Acount #

Bank Phone #

Return/Replacement Policy All of Camilla Pecans products carry our 100% guarantee. If there is any loss or damage to the product, please note this on your delivery receipt and call us immediately. 1-800-526-8770. We will not be able to accept returns after 5 days from delivery date. Credit Terms Our terms are standard prepaid unless prior credit approved. Once credit is approved payment must be received within 30 days from shipment. AUTHORIZED By typing I UNDERSTAND you are authorizing Camilla Pecan to obtain, confirm or request further information concerning such information and/or your credit standing from others including credit reporting agencies.:

I UNDERSTAND

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