Wasem Packaging & Crating Service
2591 Harrison Road Columbus, Ohio 43204
Ph: (614) 279-6413 Fax: (614) 279-2736

Credit Application

Business Name:________________________________________________



State or Province:____________________________________________

Zip or Postal Code:____________________________________


How many years at address:______________________


Phone #:_______________________________________

Fax #:_________________________________________

Federal Tax ID # or SS #:_______________________________


Sole Owner   /    Partnership   /    Corporation

Principal (name) (title) :_______________________________________________

Principal (name) (title) :_______________________________________________


Sales Manager:______________________________Phone #_____________________

Accts Payables:______________________________Phone #______________________

Purchase Orders Required?_____________________


(Name, Address, Phone/Fax number and Account Number)

1. Name:___________________________________________________________


( City, State, Zip )_________________________________________



Account#: __________________________________

2. Name: __________________________________________________________

Address:(street )_________________________________________

( city, state, zip )__________________________________________

Phone: _______________________________

Fax: _________________________________

Account#: __________________________________

3. Name: ________________________________________________________

Address:(street )_______________________________________

( city, state, zip )________________________________________

Phone: _____________________________

Fax: _______________________________

Account#: ________________________________


(name)(address)(acct#) (phone/fax#) Checking Loan Savings Phone or Fax # Required  

Name: ___________________________________________

Address (Street ): ______________________________

( city, state, zip )_______________________________

Account#: _____________________________________

Phone: ______________________________

Fax: ________________________________

(name)(address)(acct#) (phone/fax#) Checking Loan Savings Phone or Fax # Required

Name: ______________________________________________

Address (Street): _________________________________

(city, state, zip)____________________________________

Account#: _____________________________________

Phone: ____________________________________

Fax: ________________________________

I hereby authorize my bank to release any information needed on account# to
Wasem Packaging & Crating Service



Number of Employees:__________   

Est. Annual Sales $ _______________________  

If No you do have a website, please list ALL websites you
Sell on or plan to sell on:(If you do not have a website enter none)



Has your company or any of its Principals ever filed bankruptcy? ________________

If yes, Explain:___________________________________________________________


Do you want an email confirmation with tracking information when your order ships?

Yes  / No  

Any misrepresentation in this application will be considered evidence of fraud, since This
information is the basis for granting credit. As an inducement to grant credit, The undersigned
warrants that the information submitted is true and correct. You are authorized to investigate
the credit reference listed. You have read the terms page listed on our web site and here by


(Title)__________________________________ (Date) ______________________

Personal Guarantee

In consideration of credit being extended by Wasem Packaging & Crating Service, to the above
named applicant for merchandise be purchased whether applicant be an individual or
individuals, a proprietorship, a partnership, a corporation, or other entity, the undersigned
guarantors each hereby contract and guarantee to Wasem Packaging & Crating Service the
faithful payment, when due, of all accounts of said applicant for the purchases made after the
date of this application. The undersigned guarantor or guarantors each hereby expressly waive
all notice of acceptance of this guarantee, notice of extension of credit to applicant,
presentment, and demand for payment on applicant, protest and notice to undersigned
guarantor or guarantors of dishonor or default by applicant or with respect to any security held

(Your name) _____________________________________________,

Any extension of time of payment to applicant, acceptance of partial payment or partial
compromise, all other notices to which the undersigned guarantor or guarantors might
otherwise be entitled and demand for payment under this guarantee. Absent written permission
by creditor, this personal guarantee may not be revoked. The undersigned guarantor or
guarantors, hereby agree to pay 1.5% interest rate per month for any balance outstanding
within (30) days of billing. The undersigned guarantor or guarantors hereby agree to pay
reasonable attorney’s fees; in addition, court costs for any unpaid balance within (90) days of
the date of billing. You have read the terms page listed on our web site and here by agree.

(Signature)_______________________________ (title)________________________

(Drivers License #)________________________
Credit Application