Robosson Supply, Inc. 5329 Enterprise Street Sykesville, MD 21784 Ph: (410)795-1621 Fax: (410)549-6909 www.robossonsupply.com Date:___________________ Credit Application Name of Firm or Corporation: ___________________________________________________ Address:____________________________________________________________________ City:________________________________ State:____________________ Zip:___________ Phone:___________________ Fax:______________E-mail Address:____________________ Would you like to be added to our e-mail contact list to receive updates on our products and specials? _____Yes, please send us your specials and updates on products via e-mail. _____ No, please do not e-mail us anything other than what we specifically request. The following information is submitted for your consideration as a basis extension of credit to us: We operate___________________________. We have been established for ________years. (Type of Business) Our legal entity is: ___ Corporation ___ Co-Partnership ___ Proprietorship (If a corporation, list the names of officers and titles, if other entity, list the names of partners or owners.) Name Title Address City, State, Zip ____________________ _______________ ____________________________ _________________________ ____________________ _______________ ____________________________ _________________________ ____________________ _______________ ____________________________ _________________________ Annual Sales Volume: ______________________ No. of Salesmen: _____________________ Monthly Credit Desired:______________________ The following are four trade references that we are presently doing business with: Company Name Street Address _________________ ______________________ City, State, Zip ________________ Phone # ________________ _________________ ______________________ ________________ ________________ _________________ ______________________ ________________ ________________ _________________ ______________________ ________________ ________________ Bank Name Street Address _________________ ______________________ City, State, Zip ________________ Phone # ________________ _________________ ______________________ ________________ ________________ Date:_______________ Signed by:________________________ Title:_____________________ Authorization to Release Information I hereby authorize our bank(s) and/or the above trade references to release any information necessary to assist in establishing a line of credit. Firm name:____________________________________________________________________ Address: _____________________________________________________________________ City, State, Zip:________________________________________________________________ Authorized by:_________________________________________________________________ Personal Guaranty In order to induce ROBOSSON SUPPLY, INC.(Robosson) to sell merchandise, extend credit and/or to allow the continuation of any credit or accounts heretofore or presently existing to or from ________________________________ (Customer), or to otherwise become a creditor of Customer, the undersigned jointly, severally and unconditionally guarantee to Robosson prompt and full payment of all monies now due or which may become due to Robosson prompt and full payment of all monies now due or which may become due to Robosson by Customer, including any interest or service charge which may be applicable. This is a continuing guaranty, and shall be revocable only as to transactions entered into between Robosson and Customer subsequent to three (3) banking days following the receipt by one of Robosson’s officers of notice of termination sent by the undersigned by certified mail, return receipt requested. The undersigned waives notice of acceptance hereof, and notice of orders, sales and deliveries to Customer, and of the amounts and terms thereof, and of all defaults by or disputes with Customer. The obligation of the undersigned is a primary and unconditional obligation, and covers all existing and future indebtedness of Customer to Robosson. The undersigned hereby waives notice of each and every one of the following acts, events and/or conditions and hereby agrees that the creation or existence of any such acts, events and/or conditions or the performance thereof by Robosson (in any number of instances) shall in no way release or discharge the undersigned from liability hereunder, in whole or in part; (a) the renewal, extension, modification, refinancing or granting of any indulgence of any nature whatsoever with respect to any or all of the Accounts; (b) the addition of or partial or entire release of any guarantor, maker, surety, endorser, indemnitor, or other party or parties primarily or secondarily liable for the payment of the Accounts; (c) the institution of any suit or the obtaining of any judgement against any guarantor, maker, surety, endorser, indemnitor or other party primarily or secondarily liable for the payment of the Accounts; or (d) the sale, exchange, pledge, release or impairment of any collateral now or hereafter received to secure the Account. Any money or other property that Robosson may receive on account from any source whatsoever may be applied to any account, whether secured or unsecured, as Robosson in its sole discretion sees fit. Further, any money or other property that Robosson may receive from any source other than from the undersigned may, at its option, be applied to debts that are not guaranteed hereby (if any). All liabilities of Customer and of the undersigned shall mature immediately upon the insolvence of Customer, the appointment of a receiver for Customer or any of its property, the filing of a voluntary or involuntary petition in bankruptcy, reorganization, or arrangement, the making of any assignment for the benefit of creditors, or the calling of a meeting or creditors by Customer. Robosson’s records showing the amount between it and the Customer shall be admissible in evidence in any action or proceeding involving this guaranty, and such records shall be prima facie proof of the items therein set forth. Should any payment required by Customer or hereunder not made when due, the undersigned hereby empower any attorney of any court of record within the United States or elsewhere to appear for them and after one or more declarations files confess judgement against them as of any term of the sum then owned by Customer to Robosson with costs of suit and attorney’s fees of the greater of $200.00 or 15% of said sum for collection. The undersigned hereby waive and release all errors and all rights of exemption, appeal, stay of execution, inquisition and extension upon any levy on real estate, or personal property to which they may otherwise be entitled under the laws of any State or possession of the United States now in force or which may hereafter be passed. _____________________________ Customer’s Printed Name ______________ Soc. Security # _____________ Date _____________________________ Customer’s Signature _____________________________ Customer’s Printed Name ____________________________ Home Address ______________ Soc. Security # _____________ Date _____________________________ Customer’s Signature _____________________________ Customer’s Printed Name _____________________________ Customer’s Signature ____________________________ ____________________________ ____________________________ Home Address ______________ Soc. Security # _____________ Date ____________________________ ____________________________ Home Address