Credit Application

New Account
Secure Credit Application

6740 Broadway Avenue, Suite D
Jacksonville, FL 32254

ALL INFORMATION CONTAINED BELOW IS CONFIDENTIAL

Phone: 904-737-9989
Fax: 904-737-9022

Federal Tax I.D. *

State Resale Certificate (Attach Copy if Applicable)

NOTICE In accordance with the provision of the State of Sales & Use Tax Act we are required to collect tax on sales of taxable property or service unless the purchaser gives us a properly completed Resale Certificate or Exemption Certificate

BILLING ADDRESS

Company Name *

Address *

City *

State *

Zip *

Accounting Contact (Name) *

Phone *

Fax

Email *

SHIPPING ADDRESS

Same as Billing Address

Company Name *

Address *

City *

State *

Zip *

Shipping Contact (Name) *

Phone *

Fax

Email *

Owner / Principal *

Incorporated
Partnership
Sole Proprietorship
Other

Estimated Annual Order Volume ($)

Opening Order Amount

Credit Line Requested *

Type of Business

Trade Reference Name

Trade Reference Mailing Address

Trade Reference (Phone, Fax, Email)

Trade Reference 1

Mailing Address 1

City 1

State/Zipcode 1

Phone 1

Fax 1

Email 1

Trade Reference 2

Mailing Address 2

City 2

State/Zipcode 2

Phone 2

Fax 2

Email 2

Trade Reference 3

Mailing Address 3

City 3

State/Zipcode 3

Phone 3

Fax 3

Email 3

The above/attached information is for the purpose of obtaining credit and is warranted to be true. We hereby authorize POSPaper.com to investigate the references listed pertaining to my/our credit and financial responsibility and authorizing my/our bank to release the information requested in conjunction with establishing this credit. *Applicants signature attests The Company's financial responsibility and willingness to pay our invoices in accordance with set terms. Past due accounts are subject to a charge of 1.5% per month, 18% per Annum or the maximum permitted by law. Any exception must have written authorization from POSPaper.com. In the event any third parties are involved to collect any outstanding monies owed by said business, the customer agrees to pay any reasonable collection fees, including attorney fees whether litigation has commenced, and all cost of litigation.

Name *

Title *

Date

05/13/2026

TO BE COMPLETED BY CREDIT DEPARTMENT

Date Reviewed

Terms/Credit Limit

Approved By

Customer Service Rep.

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Credit Application

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New Account
Secure Credit Application