National Power Corporation
    Application For Credit

[FrontPage Save Results Component]
Business Name:  
Business Address:
City:                  
State
Zip
Business Phone
Business Fax
Contact Name
Billing Information
Billing Address
City
State
Zip
Billing Phone
Billing Fax
Contact Name
Business Information
Corporation  
Partnership  
Proprietorship  
Individual  
Officers/Principals:         Name Title

                                  Name

Title

                                  Name

Title

                                  Name

Title
Type of Business
Bank Information
Bank Name
Account Number
Bank Address
Bank City
Bank State
Bank Zip
Bank Phone
Bank Fax
Bank Contact Name
Trade References (Three current suppliers; omit utilities, phone and credit cards)
1.  Name Account Number  
Address  
City  
State  
Zip  
Phone  
Fax  
Contact Name  
2.  Name Account Number  
Address  
City  
State  
Zip  
Phone  
Fax  
Contact Name  
3.  Name Account Number  
Address  
City  
State  
Zip  
Phone  
Fax  
Contact Name  
Anticipated Monthly Volume  

Credit Agreement
The undersigned individual or agent for customer hereby certifies that the above information is complete and accurate, and requests that terms of credit on any account in customers name be extended at your discretion.  The customer hereby grants permission for any person to furnish to NPC any and all information which may be requested.  Customer also agrees to pay for any and all deliveries under and pursuant to its accounts, whether ordered by the customer or by any person representing himself to be an agent, employee or representative of the customer.  All sales are net 30 days and after 30 days, 1½% per month finance charge will be added to the account balance.  Thereafter, 1½% for each 30 days, or any part thereof, will be added to the account balance.  These terms are strictly enforced.  Customer agrees to pay all collection costs, the maximum attorney's fees allowed by law, and court costs incurred in the collection of said accounts in the event legal action is deemed necessary.  The undersigned personally guarantees and personally assumes full and ultimate responsibility for payment of all accounts generated by customer's orders under the terms and conditions outlined above.  NPC maintains security interest in all goods delivered until paid for in full.

Full Name:
Title:
Date:
I understand and agree to the above terms