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    DBapplication

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    GM Mainstay
    MainStay Suites is requesting companies to complete a direct bill application form to establish a commercial credit account. The form requests company contact information, billing address, bank information, and commercial credit references. It outlines the credit agreement terms including payment due within 30 days to avoid interest charges and past due accounts may result in suspension of billing privileges. The applicant agrees to provide credit card backup information that will be charged if the bill is past due by 60 days.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    DBapplication

    Uploaded by

    GM Mainstay
    36 views1 page
    MainStay Suites is requesting companies to complete a direct bill application form to establish a commercial credit account. The form requests company contact information, billing address, bank information, and commercial credit references. It outlines the credit agreement terms including payment due within 30 days to avoid interest charges and past due accounts may result in suspension of billing privileges. The applicant agrees to provide credit card backup information that will be charged if the bill is past due by 60 days.

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    MainStay Suites is requesting companies to complete a direct bill application form to establish a commercial credit account. The form requests company contact information, billing address, bank information, and commercial credit references. It outlines the credit agreement terms including payment due within 30 days to avoid interest charges and past due accounts may result in suspension of billing privileges. The applicant agrees to provide credit card backup information that will be charged if the bill is past due by 60 days.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    36 views1 page

    DBapplication

    Uploaded by

    GM Mainstay
    MainStay Suites is requesting companies to complete a direct bill application form to establish a commercial credit account. The form requests company contact information, billing address, bank information, and commercial credit references. It outlines the credit agreement terms including payment due within 30 days to avoid interest charges and past due accounts may result in suspension of billing privileges. The applicant agrees to provide credit card backup information that will be charged if the bill is past due by 60 days.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    MainStay Suites

    551 Granite Peak Dr.


    Casper, Wy. 82609
    Ph: (307) 472-7829 Fax: (307) 472-2022
    Email: [email protected]

    Company Direct Bill Application Form


    Company Name:__________________________________________________________________________
    Company Contact:__________________________Phone: ____________email:_________________________
    Accounts Payable Contact: ___________________Phone: ____________email:_________________________

    Address: ______________________________ Billing Address: _____________________________________


    ______________________________ _____________________________________
    ________________________________ _______________________________________

    COMMERCIAL CREDIT TRADE REFERENCES: (ONE HOTEL REFERENCE REQUIRED)


    NAME COMPLETE ADDRESS TELEPHONE DATE
    1
    2
    3

    BANK INFORMATION:

    BANK NAME: _____________________________________________________________________________________________

    BRANCH ADDRESS: _______________________________________________________________________________________

    ACCOUNT NUMBER(S): ____________________________________ _______________________________________________

    CREDIT AGREEMENT TERMS AND CONDITIONS

    Payment Terms – All invoices are payable upon receipt. Past Due Accounts over 30 days are subject to suspension of billing privileges
    and 1.5% interest charges every 30 days past due until account has been settled. Signature below constitutes full acceptance of an
    agreement to pay according to stated items.

    Credit Card Back-up: Account No. ______________________________________________ Exp: ___________ CCV # ____________

    Name as appears Credit Card: __________________________________ Authorized Signature:_______________________________

    Credit card will be charged if bill is past due 60 days.

    THE INFORMATION ON THIS FORM IS TRUE AND CORRECT AND IS VOLUNTARILY PROVIDED TO ASSIST HIMANSHU INC. IN ESTABLISHING A
    COMMERCIAL CREDIT ACCOUNT FOR THE WITHIN NAMED COMPANY. HIMANSHU, INC., OR THEIR AGENT, IS AUTHORIZED TO OBTAIN AND VERIFY
    CREDIT AND FINANCIAL INFORMATION FROM ANY AND ALL REFERENCES. IT IS EXPRESSLY UNDERSTOOD THAT IF CREDIT IS APPROVED, ALL
    CHARGES WILL BE PAID ON ALL PAST DUE AMOUNTS, THAT IN THE EVENT OF DEFAULT COLLECTION COSTS AND ATTORNEYS’ FEES WILL BE
    REIMBIRSED TO HIMANSHU, INC., AND THAT THE COMPANY CONTACT HEREON WILL BE RESPONSIBLE FOR ALL CHARGES UNTIL HIMANSHU, INC.
    RECEIVES NOTICE IN WRITING OF SALE OR TERMINATION OF COMPANY OR BUSINESS.

    DATE: _____________________ SIGNED: ______________________________________________ TITLE: ____________

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