Credit Application

Requirements for Credit Application*
- Open Account (Projected purchases min. $2,400/year)
Are you a current CK Supply Customer?*
- Yes
- No
If Yes, Please Provide Account Number (If Known)
Your CK Supply Account Manager (If Known)

Are Purchase Orders Required?
- Yes
- No
Will you accept invoices by email?
- Yes
- No
If Yes, please provide email below!
Email
Do you want access to an online customer portal for your account?
Online Ordering, View Invoices, Order History, Account Balances, Credit Memos, Cylinder Balances, Open Orders, Pay Bill with a Credit Card, & More!
- Yes
- No
Email for Portal Access

Our Credit Policy is Net 30 Days
I understand that the information furnished above is for the purpose of obtaining credit from your u001erm. I fully understand your credit policy and agree to your payment terms. I am authorized in my capacity, to bind my u001erm accordingly. I agree that all accounts or monies due shall be due and payable at your business. I understand and agree that all past due invoices shall automatically accrue interest at the rate of eighteen percent (18%) per annum and further agree to pay these charges. Should it become necessary to place this account with any attorney for collection, it is agreed that I/MY firm will be responsible for any and all costs of collection, including reasonable attorney’s fees.
Name
First Last
Title (Officer/Owner)
Signature

Billing Address