Customer Credit Application

Enter the three owners with the greatest ownership percentage in that order. If the entity is owned by another entity please enter the entity owner and attach a sheet with the owners, addresses, phone numbers and SSN’s and ownership percent of such entity.

Please provide information about any bank accounts, notes, mortgages, etc., and attach a sheet for additional institutions:

Please provide two trade references which the business has had open for one year or more. If none, enter the most long term relationship.

Terms are Net if paid within thirty (30) days. If an account is past due, Hopkins shall have the right to require cash on delivery. Customer agrees to notify Hopkins of any disputed invoices within thirty (30) days of the date of the invoice. Customer agrees to pay to Hopkins a service charges in the amount of two (2%) percent per month, or the maximum lawful rate, on any past due account balances. In the event Hopkins places the account for collection, Customer agrees to pay all of Hopkins’ costs of collection and collection fees, including, but not limited to, attorney’s fees in the amount of thirty-three (33%) percent of the outstanding indebtedness and court costs. Customer agrees to pay a fee of $40 for all checks or payments returned for insufficient funds or any other reason. Customer agrees to notify Hopkins by certified mail of any pending change of ownership of the Customer and further agrees to be liable for all purchases should the undersigned fail to comply with said notification.