Globe Electric accepts Visa, Mastercard and COD.  Once you have established an account with our company, terms are Net 30. Please complete the following confidential information so that we may evaluate your organization for credit.

Upon approval of an open account with Globe Electric, in the event that your account is not paid within the terms of  Net 30 from the date of invoice, your orders are subject to being held until payment is received to bring your account current.

In the event the account passes 90 days past due, the applicant is subject to being placed for collections and assessed an interest of 18% per annum, as well as all costs of collection, including reasonable attorney's fees, if collected by law or through our collection agency. A $25.00 charge will be assessed for all returned checks.

This information is submitted to Globe Electric for the purpose of securing credit. By submitting the information above, the undersigned agrees to the stated payment terms and fees in the event of default. Notification in writing must be made to Globe Electric regarding any changes in company name, address, type of business, principals in the company or tax number.

Date:*
Company:*
Contact Name:*
Title:
   
Address:*
Address2:
City:*
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Phone Number:* Fax Number:*
Email:*
Please check one:Individual Partnership Corporation
Debtor:*
Debtor Title:*
Trade References (Please provide FAX numbers and at least 3 references)
Trade Reference #1:*
Address:*
City, State, Zip:*
Phone:*
Fax:*

 		  
Trade Reference #2:*
Address:*
City, State, Zip:*
Phone:*
Fax:*

 		  
Trade Reference #3:*
Address:*
City, State, Zip:*
Phone:*
Fax:*