A copy of all current wholesale permits MUST accompany this application
975 University Avene Norwood, MA 02062 Tel (617) 776-6700 Fax (617) 440-1039 teamcreditmanager@mswalker.com
WHOLESALE CREDIT APPLICATION Date______________________ Corporation Name_________________________________________________ Tel#___________________________________ D/B/A____________________________________________________________ Fed Tax Id #_____________________________ Delivery Address__________________________________________________________________________________________ City _____________________________________________________________ State _____________ Zip _________________ Owner/Corporate Officer____________________________________________ Customer Contact________________________ Email Address:_____________________________________________________ A/P Bookkeeping Contact Name/Phone:_____________________________________________________________ (required) A/P Email Address:_________________________________________________ (preferred method) Statement Address:_________________________________________________ Permit/License Information: Company Name:__________________________________________________________________________________________ Address__________________________________________________________________________________________________ City _____________________________________________________________ State _____________ Zip _________________ Permit/License Number_____________________________________________ Date Issued_____________________________ Number of years you have owned alcoholic beverage license at this address:_______________________________________ Do you own the property where the business is located?
Yes
No
Please provide 3 credit references
Company Name
Tel#
Address
Account #
1 2 3 PLEASE NOTE: PAYMENT IS DUE 30 (THIRTY) DAYS FROM PICKUP OF PRODUCT FROM OUR WAREHOUSE. By signing this credit application, I agree to abide by all M.S. Walker, Inc. terms and conditions of sale including, but not limited to a service charge of 1% per month on all invoices outstanding thirty (30) or more days after invoice date. If customer’s account is forwarded to an attorney or collection agency for collection, customer agrees to be responsible for all costs of collection including reasonable attorney’s fees as approved by the court.
Authorized Applicant’s Signature/Title WS.02.17
OFFICE USE ONLY: MA
NY
NJ
MSW Rep Id#_________________________________________________