Credit Application

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Credit Application Form
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General Information

Business Address

Use as Mailing Address? *

Mailing Address

Sales Tax

Do you want to be exempt from paying the Sales Tax? *
If you do not wish to be charged Sales Tax, you must send a completed, signed Resale Certificate, and a copy of your sellers permit. If incomplete, Certificate is not valid and we will be required by law to charge Sales Tax. *
Maximum upload size: 6.29MB
Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png pdf doc docx.

Business & Credit Information

Financials Attachment

Please attach copies of your financial statements for the last two fiscal years. *
Maximum upload size: 6.29MB
Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png pdf doc docx.

Bank Reference

Terms & Conditions

Failure to make payment may result in delay or cancellation of shipment. The seller (PROINSO US LLC) shall remain the owner of the goods until payment is received in full from the buyer. Purchases on terms: If payment is not received upon due date, a 2% Monthly Interest Rate will be charged. The undersigned agrees to pay reasonable attorney’s fees and court costs in the event that legal action becomes necessary for the collection of any sums of money due to PROINSO US, LLC under this agreement. By signing below I (we) agree to the above credit terms.

Statement of Accuracy and Permission to Verify

I hereby certify that the information contained herein is complete and accurate. This information has been furnished with the understanding that it is to be used to determine the amount and conditions of the credit to be extended.
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