Credit Application

If you prefer you can download the PDF version for submission.

Your submittal of this application implies your acknowledgment and acceptance of the Serverli Terms and Conditions shown at the bottom of this form.

Business Trade Name

Business Legal Name

Business Phone

Country/Region

Address

City

Zip / Postal code

Length of time operating the above named business

Length of time under current ownership:

Length of time at this address:

Number of Employees

Type of legal entity

D&B #:

Federal Tax ID # (TIN):

Subsidiary of:

Affiliated Business(es):

OFFICERS/OWNERS INFORMATION

Name

Title

% Ownership

Address

Email Address;

Name

Title

% Ownership

Address

Email Address;

Name

Title

% Ownership

Address

Email Address;

Annual Sales Income:

Credit Line Desired:

Anticipated Yearly Volume:

Approximate Amount of Initial Order:

For credit amounts greater than $150,000, the applicant must submit audited or reviewed financial statements not older than 12 months from the financial year end, along with this application

ACCOUNTS PAYABALE INFORMATION

Email Address

Phone #

SALE S TAX INFORM ATION Are you sales tax exempt?

If ‘YES’, please provide any state-issued sales tax exemption certificates for the states to which Serverli will be shipping.

CREDIT REFERENCES

PLEASE COMPLETE ALL FOUR REFERENCES

Creditor

Contact

Acct. #

Phone

Creditor

Contact

Acct. #

Phone

Creditor

Contact

Acct. #

Phone

Creditor

Contact

Acct. #

Phone

BANKING INFORMATION

Bank Name

Bank Address

Acct. #

Savings Account #

Loan #

Account Officer

Phone

TERMS AND CONDITION

1. Terms of Credit

Payment Terms: Payment is due in full within 30 days of the invoice date unless otherwise agreed in writing.

Late Payment: Accounts not paid within terms are subject to a late fee of 5% per month on the outstanding balance.

Returned Checks: A fee of $25 will be charged for any returned checks.

2. Authorization for Credit Inquiry

By signing below, you authorize Serverli to make inquiries into the banking and trade references provided, and to obtain credit reports and other information deemed necessary in the processing of this credit application.

3. Personal Guarantee

In consideration of credit being extended to the above-named business, the undersigned hereby personally guarantees the payment of all obligations owed to Serverli. This guarantee shall be a continuing and irrevocable guarantee for such indebtedness.

Guarantor’s Name:

Title:

Signature

Date

4. Florida State-Specific Legal Information

In accordance with Florida Statutes § 687.0304 (2023), all credit transactions are subject to the applicable usury laws governing the maximum interest rates on commercial credit. Serverli will adhere to these statutes in the event of late payments or defaults.

5. Governing Law

This Agreement shall be governed by, and construed in accordance with, the laws of the State of Florida. Any disputes arising under this agreement shall be resolved in the courts of the State of Florida, County of Orange.

6. Collection and Attorney Fees

In the event that legal action is necessary to collect on the account, the applicant agrees to pay all collection costs, including reasonable attorney fees.

7. Notice of Right to Cure

As per Florida law, the applicant has the right to cure any default within the period specified by applicable law. Failure to do so may result in legal action for recovery of the debt.

8. Miscellaneous

Serverli reserves the right to withdraw credit or limit the applicant’s credit line at any time for any reason.

Changes to the applicant’s ownership or business structure must be reported to Serverli in writing within 30 days.

By signing this application, I acknowledge that I have read and understand the terms and conditions of sale and agree to abide by them.

Authorized Representative Signature

Print Name

Title

Date

Email Address

Company Represented

Info@serverli.com