Credit Application

Mountain Filtration Systems, Inc.
5433 Industrial Ave. Ste 4
Altoona, PA 16601

Phone: 800-296-3005
Fax: 800-821-6553

Credit Amount Required:

Resale License #:

Company Name:

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FAX :

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If affiliate, indicate Company:

Home Office Location:

Years In Business:

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Trade References (Three Major Suppliers)

Trade Reference #1

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Acct #:

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Trade Reference #2

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Acct #:

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Fax#:

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Trade Reference #3

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We, the above named firm, hereby make application for credit and provide the information herein, which is warranted to be true and correct. In consideration thereof, it is agreed and understood that our terms are net 30 days: (1) The undersigned is an authorized agent of the applicant and is duly empowered to enter into and make binding agreements in just behalf. (2) All account balances are due no later than 30 days from the invoice date. (3) Delinquent accounts can be accessed at 2% per month interest, up to the maximum legal limit, whichever is lower. We agree that, in the event of default of payment when due, all cost of collection, including attorney’s and court costs, shall be paid by the applicant. It is understood that this application for credit shall be governed and construed under the laws of the state of Pennsylvania, and we will consent to the jurisdiction of the Courts located in Blair County, Pennsylvania. (4) In the event of default of payment when due, all products purchased shall remain the property of MOUNTAIN FILTRATION SYSTEMS, INC. until funds transfer has been completed.

Signed: