Payard Patisserie & Bistro

1032 Lexington Avenue

New York, NY  10021

Tel: (212) 717-5252 – Fax (212) 717-0986

 

 

CREDIT APPLICATION

 

 

Date:                ___________________

 

Legal Name:     ______________________________            D/B/A: _________________________________

 

Address:           ___________________________________________________________________________

 

Tel:                   ________________    Fax:      _______________      Federal Tax ID #: __________________

 

Corporation / Sole Proprietorship / Partnership / Other  _______________________________________

(Circle one)                                                                                                            Date Incorporated

 

Date Business Established: __________           Type of Business _____________________________________

 

Officers’ Names:                      Address                                                                       Tel. No.:

1)_____________________________________________________________________________________

2)_____________________________________________________________________________________

3)_____________________________________________________________________________________

 

Person to contact regarding account status: _____________________ Tel: _________________Ext.______

 

Credit Reference

Trade Name                                                     Tel No.                                                            Contact

1)

 

2)

 

3)

 

Bank Reference

 

Bank Name & Address                                                Tel No.                        Account No.                Contact

 

1)

 

2)

 

 

I (we) authorize the above mentioned references to release the information necessary to establish credit with your company.  PBS Foods, LLC d/b/a Payard Patisserie & Bistro agrees to hold this information in the strictest of confidence.

 

I (we) further agree to the terms of sales and payment with Payard Patisserie & Bistro.  Payment for a previous month is due on or before the 15th of the following month.  Late payment (payment received after the 15th) will result in a 10% interest charge.

 

___________________________________                                                              _____________________________          Company or Corporate Name                                                                  Signature: Owner, Partner or Officer