100 Hillside Drive, Drums, PA 18222, USA • Tel: 1-866-273-3243 •

New Account Application Form

* marked fields are compulsory.
Certain restrictions apply to internet only sellers. Please contact us for more information. 866-273-3243 or Sales@jpcequestrian.com.
Opening order must be at least $2,500-we only accept credit card payments for all customer orders
Company Name*
Phone*
Fax
E-Mail*
Web Site
Billing Address*
City* State* Zip*
Shipping Address
Same as the Billing Address
Shipping Address*
(if different from above)
City* State* Zip*
Date Established*
Type of Entity*
Proprietorship Partnership Corporation Other
If Incorporated*
Yes No
If Incorporated
Date of Incorporation Resale #* *Please attach copy of current state resale certificate
Business License #*
Federal Tax ID #*
Are you a FBA dealer?*
Yes No
Principals/Owners - 1  
Full name*
Title*
Address*
Mobile Number*
Principals/Owners - 2  
Full name
Title
Address
Mobile Number
Trade References - 1  
Name*
Address*
Phone*
Fax
Trade References - 2  
Name
Address
Phone
Fax
Trade References - 3  
Name
Address
Phone
Fax
Bank Reference  
Name*
Address*
Phone*
Fax
# of years with bank*
Bank Contact Person*
 
The undersigned hereby makes application for credit and provides information contained herein, which is warranted to be true and correct, for the purpose of inducing JPC Equestrian Inc, to make periodic sales of goods and materials or service to it on credit. In consideration there of, it is agreed and understood that the undersigned is an authorized agent duly empowered to enter into and make binding agreements on its behalf; all amounts charged under the account are payable in full within the terms established for the account; all payment shall be made to JPC Equestrian at above address; in the event of default in payment amount due, the balance of the account shall at our option be due and payable immediately; and if account is placed in the hands of an agency or attorney for collection or legal action to pay reasonable collection fees to offset the cost of collection including agency, attorney fees and court costs. The customer further agrees that it shall not permit or suffer any change in customer ownership or the sale of all or substantially all of the customers assets without providing prior written notice to JPC Equestrian Inc and establishing arrangements for payment of the outstanding amount owed JPC Equestrian Inc. Failure to provide JPC Equestrian Inc with prior written notice in change of ownership or a sale of customers assets shall cause the undersigned customer and each principal to remain fully liable to JPC Equestrian Inc, with respect to all amounts owned by the undersigned and such successor. Finance charge of 1.5% will apply to unpaid balances after 30 days.

The undersigned, hereby consents to and authorizes the use of a consumer credit report on the undersigned, by the above name business credit grantor as needed in the credit evaluation process.

Signed*
By*
Date*
 
Full Name of Firm
 
Name of Authorized Agent
   

 
In consideration of the credit being extended to the above named firm after initial 90 days, and the indirect benefit received by the undersigned by virtue of such credit extension, the undersigned does hereby personally guarantee and become surety for all amounts owed to JPC Equestrian Inc, by the above name firm. This Guaranty & Suretyship is absolute, unconditional and continuing. The undersigned does hereby waive and consent to any rearrangement, extension, modification, amendment and/or renewal of the indebtedness hereby granted without prior notice or any approval. In the event this Guaranty is placed for collection, the undersigned agrees to pay all costs of collection and reasonable attorney fees. If signed by more than one peron, the liability hereunder shall be joint and several. Intending to be legally bound hereby, the undersigned sets the hands. This Guaranty and Suretyship shall be governed by and construed under the laws of the Commonwealth of Pennsylvania.
Date
Name
 
 
 
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  Terms and Conditions are understood and submission of the form may be construed as a signed form.