Credit Application

Fields marked with a '*' are required.

Company Name:
*
Address:
*
City:
*
State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming *  Zip Code: *

Phone Number:   *

Email:  

Type of Business: Proprietorship Partnership Corporation Years Est:

Principal Products:

Draperies

Interior Dec.

Upholstery

Other:

Sales Tax #: *

TRADE REFERENCES (* at least 2 required)

Name	Account #	Street	City/State	Zip

Type of Account desired with:

Carolyn Fabrics: none Open COD credit card *

P. Collins, Ltd. : none Open COD credit card *

Bank:

Bank Officer's Name:

Address:

Is this business a Branch, Division, or Subsidiary of another Business? No Yes (If Yes, you must send us a letter that the parent company will guarantee credit)

Will you accept COD shipment until credit is established? Yes No (If No, order will not be shipped until credit is established)

Names of Principals in the Business	Social Security Number
*	*

***Please note: we will also send you a completed credit application to sign for our records.***

"TERMS"

I, we, or either of us request a credit account with Carolyn Fabrics, Inc. / P. Collins, Ltd. and furthermore agree to the "TERMS" and conditions as stated on this application and invoices. Our "Terms" are, all invoices due net 30 days after purchase, payable at our General office at P.O. Box 2758, High Point, Guilford County, North Carolina. In the event this account is not paid according to our terms of the venue of any action filed in Court will be in Guilford County, North Carolina. Purchaser agrees to pay reasonable attorney fees if referred to attorney for collection. Merchandise returned for credit must have approval and show invoice number. "I hereby certify that the foregoing statements and representations on the application are true correct as of this date." I personally guarantee payment of the above account.