Application Form:

Business Name: Phone:

Business Address: City: State: Zip:
How long in business? P.O. Number Required?
Monthly credit amount requested?
Trade References:
1.) Name: Phone:

Address: City: State: Zip:
2.) Name: Phone:

Address: City: State: Zip:
3.) Name: Phone:

Address: City: State: Zip:
4.) Name: Phone:

Address: City: State: Zip:
5.) Name: Phone:

Address: City: State: Zip:
For Corporation: Federal ID #:
President: Vice President:

Phone: Phone:

Address: Address:

State Incorporated: Date Incorporated:

For Partnership:
1.) Partner: Address:

Home Phone: Social Security #:

2.) Partner: Address:

Home Phone: Social Security #:

For Sole Proprietor:
Owner: Address:

Phone: Social Security #:

Property Value: Leased:


Bank Name: Bank Address:

Account #:

Insurance Provider: Ever had a fire loss?
Value of Inventory: Secured?
Accounts Receivable Balance: Secured?
I represent by my typed name that I have read and agree to terms below.
First and Last Name:

Terms and Conditions

Terms: 2% 10th, Net 25th, Past Due 26th

All billing periods end on the 25th of the each month. A 2% cash discount will be allowed on payments made on or before the 10th of the month following the close of the billing period, and become net thereafter.

Payments not received by the 25th will be considered past due and the account will be put on credit hold until paid in full any payment past due is subject to a service charge of 1.5% per month. This is an effective annual rate of 18% monthly statements will be mailed at the end of the billing period.

Conditions of Sale:

Title of goods remain in seller until paid in full prices are subject to change without notice. All shortage claims must be filed within 24 hours. No merchandise shall be returned without prior authorization from Star or B&M all credits will be issued within 48 hours of receipt of goods at Star or B&M except labor claims which will be issued upon receipt of credit from the factory. All new returns are subject to a 10% restocking charge unless returns are made to clear account balance which are then subject to a 25% handling charge.


All collection costs, including, but not limited to. Collection agency fees, reasonable attorney fees, court costs and interest shall be paid by customer.