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Tuesday, July 07, 2020

Business Application

Print out & Email Back to This email address is being protected from spambots. You need JavaScript enabled to view it. - until we have better

Payment is due upon reciept for customers we deliver to or take orders from: We ship Fedex Ground & Fedex LTL 

Do you have a loading dock? Y or N          - This helps for LTL & will reduce cost & than you can order Beverages

Lancaster Trading House, Inc. / Hempzels© , Natalie's Choice™ 1-800-USE-HEMP
¨ Lancaster Trading House, Inc.  Brands ¨ Hempzels©    ¨ Natalie's Choice™  (Please Check One)
  Check One: Corporation
    Proprietorship Agency  
  Official Name of Firm:    
  Trade Name of Firm:    
  Year Incorporated:   Under State Laws of:    
  Address 1:    
  Address 2:    
  City / State / Zip:    
  Phone Number:   Fax Number:    
  Home Address of Corporate Officers, Partners, Owners, etc.      
  Name & Title Address City / State Zip Code Telephone  
  Bank Reference          
  Bank Name:   Branch:    
  Bank Contact:   Telephone:    
  Account Number:        
  Four Firms now extending credit (List Business References First)    
  Name Address City / State Zip Code Telephone  
  The undersigned hereby authorizes Lancaster Trading House, Inc. to obtain credit information pertaining to the  
  undersigned and if an account relationship is formed, the undersigned authorizes Lancaster Trading House, Inc.  
   to disclose credit information for the undersigned account to third parties.  
  Lancaster Trading House, Inc. requires payment within 10 days of invoice date unless otherwise contracted.  
  Brokers are jointly and severally liable to the House  for payment due  
  hereunder and the House  may hold either liable therefore.  If payment is not made within terms and the  
  matter is assigned for collection, any previously allowed agency commission is deemed as waived by the  
  customer and broker assigned.  In the event of default in payment of the above account customer and broker are   
  jointly and severally liable for collection and court costs including a reasonable attorney's fee.  
  Completed By   Name of Firm  
  Title   Date  

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