Credit Application

We welcome your interest in doing business with our company! All information submitted will be held in strictest confidence and used solely for reference purposes within our credit department. It will take about 3 ~ 5 days to response your inquiry.

* indicates the required field.

MINIMUM FIRST ORDER: $1,500

Amount of credit requested $:

*(Minimum $1500)

DUNS/Tax ID #:

1. TELL US ABOUT YOUR COMPANY:

Is Your Organization Sales Tax Exempt?

Yes No *

Is a Purchase Order Required?

Yes No *

Full Legal Name/Business Entity:

Doing Business As:

Business Address *

Address Line 1

Address Line 2

City

State: * Zip: *

Phone No.:

Fax No.:

Mailing Address (if Different)

Mailing Address Line 1

Mailing Address Line 2

Mailing City

Mailing State: Mailing Zip:

Mailing Phone:

Mailing Fax:

2. ACCOUNT INFORMATION

Name of Main Contact:

Email Address:

Phone #:

Fax #:

Authorized Purchasers:

Purchaser 1: *

Purchaser 3:

Purchaser 5:

Purchaser 2:

Purchaser 4:

Purchaser 6:

Accounts Payable Contacts:

Contact 1:

Contact 3:

Contact 5:

Contact 2:

Contact 4:

Contact 6:

I authorize Wine County Gift Baskets, 4225 N. Palm Street, Fullerton, CA 92835-1045 to receive full information as requested
relating to our credit experiences. Wine Country Gift Baskets reserves the right to request any additional information as
pertaining to your credit history. I affirm that all information provided is correct.

By typing your name below, You agree that this is valid as your signature.

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NONPAYMENT
You understand that all purchases will require authorization. If your account balance is delinquent or in default, we may not authorize a purchase and we, at our discretion, may cancel your account.

TERMS
Terms are net 30 days from date of shipment. Freight terms are F.O.B. Fullerton unless delivered by UPS/FedEx.

DISCOUNTS

Order Total

Total Discount

$4,000 - $7,999

10%

$8,000 - $11,999

12%

$12,000 +

15%

RETURNED CHECK CHARGE
We will charge you a returned check charge of $20.00 for each check that is returned unpaid.

ACCEPTANCE OF AGREEMENT/PROMISE TO PAY
The use of your account by you or anyone whom you authorize or permit to use your account means you accept this agreement. You agree to pay in U.S. dollars for all purchases, including applicable finance charges and other late fees and charges, incurred by you or anyone you authorize or permit to use your account, even if you do not notify us that others are using your account. All checks must be drawn on funds on deposit in the U.S.