BUSINESS CREDIT APPLICATION
If Applicant is not a natural person but instead a legal identity, please click here to be directed to the form for legal identities.
ASSUMED NAMES USED BY APPLICANT, IF ANY:
BILLING ADDRESS FOR APPLICANT:
In consideration of credit hereby, heretofore and/or hereinafter extended to Applicant by Tomeldon Co., Inc. d/b/a Pharmacy Solutions (“Pharmacy Solutions”) for goods/products sold by Pharmacy Solutions on account to Applicant, Applicant declares that all information provided by Applicant to Pharmacy Solutions is true and correct, then no material information has been omitted, attests to the Applicant’s financial solvency and agrees to pay all obligations as they become due. Applicant understands payment terms to be 21 days from receipts of goods. Applicant agrees that credit extension is at the sole discretion of pharmacy Solutions and may be withdrawn by Pharmacy Solutions at any time. If Applicant not a natural person, the signatory below represents that he/she has authority to execute this Agreement on behalf of the said entity. Applicant authorizes Pharmacy Solutions to make inquiries and investigation, as it deems necessary for credit purposes.
Applicant agrees that all purchases made and credits extended are subject to the following TERMS and CONDITIONS:
Name of signer:
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Document Name: BUSINESS CREDIT APPLICATION
Agree & Sign