Credit Application for AMG Publishers

Customers desiring to purchase on a net account basis from AMG Publishers must complete the form at the bottom of this screen.

You may also dowload this form and fax it to our offices. Our fax number is (423) 648-2244. Click on the form provided on the screen to the right to dowload a PDF version of the "Credit Application Publishers" from AMG Publishers.

This download form is in a PDF (Adobe Acrobat) format. If you have Adobe Acrobat Reader installed on your computer, you should be able to view the attachment easily. If not, you may download the Adobe Acrobat Reader at the following website...click here or paste the following link into your URL browser:

http://www.adobe.com/products/acrobat/readstep2.html

If you have any questions regarding these forms, please contact our customer service department at sales@amgpublishers.com or call toll-free (800) 266-4977 (continental US & Canada) or (423) 894-6060 (international calls).

Thank you.

AMG Publishers

Credit Application Form

Corporation
Proprietorship
Partnership
Customer Name
Bill to Address
City,State,Zip
Years in Business
Telephone Number (no hyphens)
Fax Number (no hyphens)
Email Address (optional)
Accounts Payable Contact Name
Accounts Payable Contact Phone (no hyphens)
Principal`s Name & Title
Social Security Numbers (no hyphens)
Home Address
City,State,Zip
Authorized Buyers Name(s)
Bank Name
Bank Address
Bank City,State,Zip
Account Number (include hyphens)
Bank Phone Number (no hyphens)
First Supplier Name
First Supplier Address
First Supplier City,State,Zip
First Supplier Phone Number (no hyphens)
Years in Business with Supplier 1
Second Supplier Name
Second Supplier Address
Second Supplier City,State,Zip
Second Supplier Phone Number (no hyphens)
Years in Business with Supplier 2
Third Supplier Name
Third Supplier Address
Third Supplier City,State,Zip
Third Supplier Phone Number (no hyphens)
Years in Business with Supplier 3
EIN Number (no hyphens)
Resale/Tax Exempt Certificate number (no hyphens)
Electronic Signature (type name)
Date Executed (month/day/year)
Please Enter Code Into the Textbox Below (code is case-sensitive):
This form is protected by 128-bit SSL encryption.

Customer hereby authorizes AMG Publishers (“AMG”) and CLW Communications Group, Inc. to contact the above listed bank and suppliers as part of their normal credit investigation. Customer hereby consents and agrees to all of the following terms and conditions:  The title and right of possession to all materials remain with the seller until the seller has received the full purchase price therefore in cash.  Customer agrees to pay all balances in full with 30 days.  Overdue balances are subject to interest charges of 1 ½ % per month or portion thereof until paid.  In the event of nonpayment, Customer agrees to pay all costs of collection, including agency fees, court costs, attorneys’ fees and other reasonable and necessary cost in an amount not less than 33 1/3 % of the unpaid principal and interest.  Credit will not be issued on goods returned unless returned with the prior consent of AMG. Customer agrees that any dispute regarding any of the transactions which may arise between it and AMG will be heard in the state or federal courts having jurisdiction in Hamilton County, Tennessee and the undersigned agrees to subject himself/herself and/or company to the personal jurisdiction of such courts.  The undersigned warrants that he/she is authorized to execute this credit application and to make this agreement for and on behalf of Customer, and by signing this application he/she also personally guarantees any indebtedness incurred by Customer.

NOTE:  Credit investigation, credit line and account number will be assigned upon receipt of first order.