creditapplication

CUSTOMER INFORMATION

Application Name:____________________________________________    A/P Contact:_______________________________

Business Address:___________________________________________     City/State/Zip:______________________________

Billing Address:______________________________________________    City/State/Zip:______________________________

Phone: ________________________    Fax: _______________________      Email:___________________________________

A/P Phone: ______________________    Fax: ______________________      Email:___________________________________

P.O. Required? Yes        No                 Recurring Credit Card Payment? Yes          No
                                                                      (Must include certificate)              (Must include Credit Card Sales Form provided by SOS)
Please check one:        Corporation                Partnership                Sole Proprietor                Individual

Owner/Officer:_______________________________________________         Title:___________________________________

Federal Tax ID # ____________________     Resale #_____________________    DUNS # _____________________________

Social Security # _______________________     Driver's License # ____________________________ State_______________
(social security # is required for Partnership, Sole Proprietor, or Individual)

Bank Name:____________________________      Address:_____________________________________________________

Bank Phone:_______________________        Account # ____________________     Contact: ___________________________

TRADE REFERENCES

Reference 1: ____________________________________________             Contact:__________________________________

Address:________________________________________________            City/State/Zip:______________________________

Phone:_________________________________ Fax:______________          Email:___________________________________

Reference 2: ____________________________________________             Contact:__________________________________

Address:________________________________________________            City/State/Zip:______________________________

Phone:_________________________________ Fax:______________          Email:___________________________________

OTHER

Have you ever filed bankruptcy Yes                No

Storage on Site, LLC ("S.O.S") may charge interest on any past due balance at maximum rate allowed by law with said interest
being calculated from the date of default. In consideration of Storage on Site extending credit to the above business or person, I/we
do hereby agree jointly and individually, to pay for all goods, wares and merchandise supplied to me or to any of us or the above
business. In the event that the account is placed with a third party for collection, I/we agree to pay all costs including reasonable
attorney fees, court costs and finance charges.

Signature attests that the information provided is accurate, complete, gives authorization to check credit, financial and banking
history, and accepts that invoices are due upon receipt.

Individual signing below is an authorized officer and or signer for the company listed above.

____________________________________________                        __________________________
Authorized Signature                                                                                             Date

___________________________________________________                         ______________________________
Print Name                                                                                                             Title

FOR STORAGE ON SITE USE ONLY

Branch #_______________      Sales Rep# and Name:___________________________

Type of Business: ________________      SIC: ____________      COD? Yes         No          National Account? Yes         No

Unit Size and Type:____________________________ Quantity:_______________ Customer # (A/R Issued):___________

__________________________________________________________________________________________________