Coletta's Downtown Auto Service, Inc.

Coletta's Downtown Auto Service, Inc. allows for its regular customers to hold open accounts. Please have an authorized representative of your company fill out the following form to apply for an account. Upon reference checks your company's representative will be contacted to inform you of the status of the application.

Business Name:

Business Address:

Reply Email Address:

Telephone Number:

Amount of Credit Requested:

Type of Business:

Owner or Principal:

Address:

Company Officers:

Bank Reference: (Name, Address, Phone, Account Number, Account Rep...)

Trade References: (Name, Address, Phone, Contact)
1)
2)
3)
4)

Tax Exempt:

If exempt, a completed exemption certificate must be mailed with a print-out of this application to:
Coletta's Auto Service 425 Richmond Street, Providence, RI 02903 or faxed to 401.331.2595.

I certify that all statements accompanying and contained in this application are true and are made for the purposes of obtaining credit and in consideration of Coletta's and/or subsidiaries selling to me or to my agent(s). I agree to the following terms:
1. To pay the account in full within the terms given to my account.
2. To pay a service charge for late payment, computed as an annual percentage rate of 18% (periodic monthly rate of 1 1/2%) or such other rate as then may be in effect on all balances remaining unpaid 30 DAYS after date of purchase.
3. If this account is placed for collection, I agree to pay all reasonable charges for collection including attorney's fees.
4. The undersigning individual personally guarantees payment of all bills of the applicant.

I ACCEPT

Name of Authorized Officer or Principal: