Credit Application

Bozeman Brick Block & Tile
1110 North Rouse
Bozeman, MT 59715
Ph. (406) 587-4284 · Fax (406) 586-7029

Credit Application
Thank you for your interest in our company. Please complete this form entirely so we may have an accurate record for sales and credit purposes. Our credit terms are on this form. If you need further information, please call our offices at the numbers listed above. After completing this form, please fax or mail it to our office.
Business Application

Individual Or Joint Application

Name: SSN:
Spouse's Name: Spouse's SSN:

Address:
City: State: Zip:
Do You: Rent Own

Years At Current Address:

Previous Address:
City: State: Zip:
Years At Previous Address:

Occupation: Employer: Years Employed:
Employer Address: Employer Phone:

Primary Purpose Of Account


New Construction	Painting	Cabinetry	Masonry	Sand/Gravel
Remodel	Electrical	Finish Work	Earth / Well Ex.	Tools
Maintenance	Drywall	Concrete	Snow Removal	Handyman

Estimated Yearly Purchases

$0 - $1,000

$1,000 - $5,000

$5,000 - $10,000

$10,000 - $50,000

$50,000+

Business Credit References Only

Name Of Business: Address:
Daytime Phone:

Name Of Business: Address:
Daytime Phone:

Name Of Business: Address:
Daytime Phone:

Bank Reference

Bank Name: Address:
Contact Address: Phone:

Checking Savings Loans Account Number:

DISCLOSURES REQUIRED BY FEDERAL LAW AND STATE LAW

This account is subject to the following terms and conditions:

1) This is NOT a revolving charge account. All bills are due in full on the 10th of the month following the date of purchase.

2) A FINANCE CHARGE will be imposed under the Kenyon Noble RETAIL CHARGE ACCOUNTS if outstanding balance is not paid within 30 days of the billing date shown on the periodic statement with which the customer will be furnished. The customer will incure no FINANCE CHARGE if the amount due on such period statement is paid within 30 days of the billing date.

3) The amount on which a FINANCE CHARGE may be imposed is the outstanding balance at the beginning of the billing cycle without deduction of payment or credits.

4) The amount of the FINANCE CHARGE is determined by multiplying the outstanding balance by a FINANCE CHARGE of 1.25% per month. The corresponding annual percentage rate is 15%. Minimum FINANCE CHARGE is $1.00.

5) If the outstanding balance plus any accrued finance charges are not paid within 30 days of the billing date, Kenyon Noble may elect to file Mechanic's liens pursuant to SECTION 71-3-501, ET.SEG.MCA, or pursue any other remedy provided by law. In the event it becomes necessary for Kenyon Noble to initiate any legal action hereunder it is agreed that the Court shall award costs and attorney's fees as a reasonable cost os suit.

6) BUSINESS CREDIT ACCOUNT. In the event the undersigned creditor is a contractor, such contractor shall describe the real property, and ownership thereof upon which the goods and materials shall be installed. Such description shall be furnished before any goods and materials shall be delivered hereunder.

7) INDIVIDUAL OR JOINT CREDIT ACCOUNT. All consumers shall notify Kenyon Noble of all changes of address after the execution of this agreement.

8) CHANGE OF FINANCE CHARGE RATE. A change in the finance charge rate may be made with written notice to address on this application within the 2 billing cycles prior to the effective day of the charge.

Individual Guarantee

I have read and agree to the terms as outlined in this application. I absolutely guarantee payment to Kenyon Noble Lumber Co., Inc. and/or Kenyon Noble Ready Mix for all goods and services sold and/or delivered pursuant to the above Credit Account. Individual Joint
Signature Of Responsible Party	Signature Of Responsible Party

Corporate Guarantee

I have read and agree to the terms as outlined in this application. I absolutely guarantee payment to Kenyon Noble Lumber Co., Inc. and/or Kenyon Noble Ready Mix for all goods and services sold and/or delivered pursuant to the above Credit Account.
Signature Of Responsible Party	Signature Of Responsible Party