We would like to welcome you as a Txley Customer
Please take a few minutes to give us your account information. This information ensures accuracy setting up your account and gives us the necessary information to provide you with the best service in the industry.

To be sold on open account, kindly complete and sign the attached Application for Credit and Bank Authorization.

Kindly complete and return as soon as possible to avoid delays in processing your orders.

Form can be brought into our facility.

Emailed to: info@txley.com

Faxed to: (360) 873-8074

Thanks you for choosing Txley! We look forward to servicing you!

I/We hereby apply for extension of credit. The following information is submitted in confidence .

Company Name:

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Billing Address:

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City:

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State:

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Zip Code:

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Phone:

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Fax:

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Billing Contact:

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E-mail:

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E-MAIL.

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FAX.

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Invoice E-mail Address/fax*:

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Ship To

Only if different from above and will apply to every order

Billing address:

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City:

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State:

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Zip Code:

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Special Shipping Instructions

We assume you are open for receiving 9:00am to 5:00pm Monday through Friday . Kindly Provide us with any information that may make our delivery to you as smooth as possible

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Application for Credit

Legal Name of Company:

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Year Established:

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Subsidiary/ Division of:

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City:

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State:

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Zip Code:

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Type Of Business

Corporation.

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Partnership.

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Proprietorship.

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LLC.

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Federal Identification Number:

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Initial Credit Requested:

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Principal Owner Officer1:

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Phone:

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Principal Owner Officer2:

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Phone:

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Trade References

Please list only accounts with which you have CURRENT open credit terms (no COD)

Major Trade Supplier 1:

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Account No:

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Phone No:

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Major Trade Supplier 2:

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Account No:

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Phone No:

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Major Trade Supplier 3:

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Account No:

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Phone No:

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Our Terms our NET 10 unless otherwise requested and approved All Credit Card payments are subject to a 3% convenience fee

I HEREBY CERTIFY .That all information on this form is correct .I/WE fully understand your credit terms and agree to the proper payment in consideration of extended credit i/we agree to pay 1.5% per month 18% yearly on all past due balances if our company defaults on payments of any outstanding valid invoices i/we agree to pay txley attorney fees collection expenses and all court costs arising from failure to pay MUST BE SIGNED BY AN OFFICER OR PRINCIPAL OF THE COMPANY IN ORDER TO BE PROCESSED

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name:

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tiitle:

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date:

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Bank Authorization

Bank Name:

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Account Number:

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Bank Address:

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City:

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State:

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Zip Code:

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Bank Phone:

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Bank Fax:

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Bank Contact Name:

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Bank E-mail:

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Special Shipping Instructions

Application for Credit

Trade References

Bank Authorization

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Ship To

Special Shipping Instructions

Application for Credit

Trade References

Bank Authorization

Call us today at (360)545-4433 or Email us at nupur@txley.com