Instagram

This field is for validation purposes and should be left unchanged.

Customer Delivery Information

Receiving Hours – Opening*

Receiving Hours – Closing*

Delivery Options

Commercial

Residential

Forklift Unload

Hand Unload

Truck Size

Pickup

Bobtail

Semi-truck

Digital Invoice Email*

To receive alerts on your delivery status through text and/or email, please fill out the information below:

Delivery Alerts Cell Phone

Delivery Alerts Email

Name of Business*

Phone Number*

Fax*

Billing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Shipping Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Type of Business*

Year Established*

Please Check:*

Individual

Partnership

Corporation

Other

Tax Status*

Taxable

Exempt

Federal Tax ID*

Resale No.*

Business Email Address*

Cell phone Number*

Spouse's Name (Individual Only)

Do you operate branches?*

Yes

No

Location(s)

Monthly Credit Requirement Approx ($)*

Dun & Bradstreet Rating

Full Name & Home Address of Corporate Officers, Owner(s) or Partners

Name #1*

Title #1*

Social Security #1*

Address #1*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Add another Corporate Officer, Owner, or Partner?

Yes

No

Name #2

Title #2

Social Security #2

Address #2

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Add another Corporate Officer, Owner, or Partner?

Yes

No

Name #3

Title #3

Social Security #3

Address #3

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Add another Corporate Officer, Owner, or Partner?

Yes

No

Name #4

Title #4

Social Security #4

Address #4

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Trade References (Avoid Using Credit Card References)

Trade Reference Name #1*

Trade Reference Fax #1*

Trade Reference Address #1*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Add another Trade Reference? (#1)*

Yes

No

Trade Reference Name #2

Trade Reference Fax #2

Trade Reference Address #2

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Add another Trade Reference?

Yes

No

Trade Reference Name #3

Trade Reference Fax #3

Trade Reference Address #3

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Add another Trade Reference?

Yes

No

Trade Reference Name #4

Trade Reference Fax #4

Trade Reference Address #4

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Name of Bank*

Account Number*

Bank Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Type of Account*

Checking

Savings

Loans

Bank Phone*

Bank Fax

Equipment Financed By

Equipment Finance Address

Equipment Loan Balance

Equipment Monthly Payments

Business Property Ownership*

Own

Lease

Business Property Cost

Business Property Value

Business Property Loan Balance

Business Property Monthly Payments

Business Property First Trust Deed (Mortgage) Holder/Landlord

Business Property Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Personal Property Ownership*

Own

Lease

Personal Property Cost

Personal Property Value

Personal Property Loan Balance

Personal Property Monthly Payments

Personal Property Title Holder

Personal Property Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Annual Sales*

Current Liabilities*

Current Assets*

Total Liabilities*

Total Assets*

Net Worth*

1st Corporate Partner Signature

Print Name (Officer/Partner 1)*

Signature (Officer/Partner 1)*

Title (Officer/Partner 1)

Print Name (Officer/Partner 2)

2nd Corporate Partner Signature

If applicable

Signature (Officer/Partner 2)

Title (Officer/Partner 2)

3rd Corporate Partner Signature

If applicable

Print Name (Officer/Partner 3)

Signature (Officer/Partner 3)

Title (Officer/Partner 3)

Terms & Conditions

Terms and Conditions

Delivery dates at a time of order are approximate and may vary due to unforeseen delays. Seller is not liable for any damages to Buyer for delays or late shipments. Title and risk of loss passes to Buyer upon delivery of goods. Buyer grants Seller a security interest on goods until paid in full.

All return of goods must have prior written approval of seller. Returns are subject to a 20% of invoice restocking charge.

Written quotes will be honored for no longer than 30 days. Buyer shall pay the current effective price at time of delivery including all shipping costs and proper taxes. Prices subject to change without notice.

Payment terms are stated on face. A $25.00 fee will be charged on returned checks.

Seller makes no implied or expressed warranties of merchantability or usability of products for any particular application or purpose. Buyer is responsible for any and all testing for intended use of products. Seller is not liable for incidental or consequential damages. All compliance to governmental regulations, state, federal, or local, is Buyer’s responsibility.

CREDIT TERMS OF SALE: 1% 10 Days – NET 30

CONDITIONS OF OPEN ACCOUNT: In the event it becomes necessary for Peterman Lumber, Inc. to file suit to enforce payment of past due amounts, such suit may be brought at the option of Peterman Lumber, Inc. and Peterman Lumber, Inc. shall be entitled to collection fees, actual attorney fees and all costs. Buyer hereby agrees that in the event of litigation, the venue for such action shall be San Bernardino County, California or at the discretion of Peterman Lumber, Inc. All purchases are deemed made and payment is due at the principal place of business of Peterman Lumber, Inc. Service charges of 1.5% per month (18% APR) rate will accrue on all past due amounts.

Financial statements, credit information, information supplied by Buyer or by others on Buyer’s behalf shall become part of this credit application and any false or misleading information shall constitute fraud. Even though an individual may have an approved “open account” with Peterman Lumber, Inc., the acceptance of any individual order and term of payment on all sales and orders are subject to the individual approval of the Credit Manager of Peterman Lumber, Inc. All sales are made pursuant to these conditions. And all orders are received with the understanding that they are placed under these conditions.

Personal Agreement

For value received, and further consideration of any credit you may extend hereafter to that party, the undersigned guarantees the full payment to Peterman Lumber Inc. of any indebtedness incurred, whether by reason of purchase of merchandise or otherwise. The guarantor’s liability shall not be affected by the amount of credit extended or by payments made by the principal debtor. The guarantor waives notice of presentment, default, change in form, renewal, or extension of any indebtedness.

This guarantee may be revoked only by written notice of revocation sent by registered or certified mail to Peterman Lumber Inc. and shall not relieve the guarantor from liability for obligations incurred prior to receipt of such notice. The guarantee shall be binding upon the guarantor and their heirs, legal representatives, successors and assigns, and creates primary liability for any indebtedness not paid at maturity.

If this guarantee is signed by more than one person, each guarantor’s liability shall be separate and independent. If executed on behalf of a corporation, the signing party warrants the authority of the corporation to execute this guarantee. Changes in the legal form of the business or ownership shall not affect this guarantee. The guarantor waives homestead exemption laws or similar protections.

In the event that an attorney is required to enforce this guarantee, the guarantor agrees to be liable for reasonable attorney’s fees and court costs. California law applies, and any litigation to enforce this guarantee may be brought in San Bernardino County, California or at the discretion of Peterman Lumber Inc.

Guarantor Print Name 1

Guarantor Signature 1

Guarantor Social Security #1

Witness Signature 1

Witness Print Name 1

Guarantor Print Name 2

Guarantor Signature 2

Guarantor Social Security #2

Witness Signature 2

Witness Print Name 2

CAPTCHA

Credit Application Form

Customer Delivery Information

Trade References (Avoid Using Credit Card References)

1st Corporate Partner Signature

2nd Corporate Partner Signature

3rd Corporate Partner Signature

Terms & Conditions

Terms and Conditions

Personal Agreement