Close Window Thanks for registering with Friend Tire! To allow us to process your application, please: 1). Print and read this page 2). Fill out the appropriate information 3). Sign and date where requested 4). Fax with ATTN: Credit Department to 1-866-322-0006 You will be contacted by a Friend Tire representative in the next couple of days. If you have additional questions, please call us at 1-800-950-8473. The undersigned, in consideration of the delivery of merchandise to the above applicant, agrees to assume any liability incurred by the above company and guarantees that payment will be made strictly according to the terms set forth herein. In the event of default, the guarantor agrees to pay court costs and reasonable attorney's fees. Owner's Signature:____________________________________________ Date:_____________ Address_______________________________   City_______________  State___  Zip________   Business Name: _______________________________________________________________ Address_______________________________   City_______________  State___  Zip________   I HEREBY CERTIFY: That I hold a valid seller's permit no. _________________. Issued pursuant of the Sales and Use tax Law: that I am engaged in the business of selling ____________________________________________________________________________. That the tangible personal property described herein which I shall purchase from Friend Tire Company, 11 Industrial Drive, Monett, MO 65708 will be resold by me in the form of tangible personal property; provided, however, that in the event any of such property is used for any purpose other than retention, demonstration, or display while holding it for sale in the regular course of business, it is understood that I am required by the Sales and Use Tax Law to report on pay tax, measured by the purchase price of such property. Descriptions of property to be purchased: Tires, Tubes, Wheels and Accessories for Resale within the United States. Signature of Owner or Authorized Agent: ____________________________________________ Date:_____________ Owner's Driver License #:____________________   CONDITION OF CREDIT: I/We hereby authorize inquiry through any investigative agency such data as would pertain to my/our credit and financial responsibility. I/We agree to a service charge of 1.5% per month, which is an annual rate of 18% on all accounts in default. If collections are made in suit or otherwise, I/we agree to pay all collections costs including reasonable attorney's fees and hereby waive all rights to claim exemption by the state laws. It is understood that title to the items purchased shall not pass to the buyer, but shall remain with the seller until paid in full. I/WE AGREE TO SIGN AN UCC-1 AND SECURITY AGREEMENT UPON CREDIT APPROVAL. TERMS: Approved credit customers have our regular terms of NET 10th. If payment is not received by the 24th of the month customer becomes a C.O.D. account and will remain a C.O.D. account until past due amount is paid in full. BAD CHECKS: Any bad check will result in a $30 returned check charge or whatever your bank charges (whichever is greater). Repeated checks of this nature will result in a Certified Check, Money Order, or Cash Payment relationship. SALES TAX: Sales Tax will be charged on all sales unless we have a signed Sales Tax Exemption card, as required by the state in our files. Owner's Signature:____________________________________________ Date:_____________