Bank References

Name__________________________    Officer_______________________________

Address________________________     Phone_______________________________

______________________________      Fax_________________________________

Account Number___________________________ Date Opened__________________

Agreement

We hereby certify that the information submitted on this application is correct and we further authorize SMC to investigate our credit and references.

It is understood that the terms being offered are Net 30 days on each purchase. If full payment of the invoice is not recieved by the payment due date, your account will be considered delinquent.

Delinquent accounts over 45 days from the date of invoice are subject to a late fee charge of 1.5% per month on the past due balances.

We understand the terms and conditions of sale and agree to pay invoices within the terms offered. We also understand that past due invoices will be subject to the late fee charges, as specified, and we agree to pay such assessed fees.

In the event of nonpayment whereby collection proceedings are involved, we agree tp pay all costs incurred by, but not limited to, attorney and collections fees.

Signature of Owner/Officer___________________________________________________________

Type of Printed Name_______________________________________________________________

Title______________________________________________ Date__________________________

 APPLICATION FOR CREDIT
Company Name_________________________________________________________________
Phone_________________________________________________________________________
Fax___________________________________________________________________________
ADDRESS:
Billing________________________________Shipping__________________________________
_________________________________ ___________________________________
Type of Business________________________________________________________________
Date Established________________________________________________________________
Accounts Payable Contact_________________________________________________________
Tax Exempt#_____________Corporation______Partenership______Proprietorship__________
Line Of Credit Requested_________________________________________________________

TRADE REFERENCES
Company______________________________Contact__________________________________
Address_______________________________Phone____________________________________
_______________________________Fax_____________________________________

Company______________________________Contact__________________________________
Address_______________________________Phone____________________________________
_______________________________Fax_____________________________________

Company______________________________Contact__________________________________
Address_______________________________Phone____________________________________
_______________________________Fax_____________________________________

Please Print this page out and Mail or Fax to Signal Measurement Corporation.