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Business Credit Application Form

Business Credit Applications have payment terms of NET 18 PROX.
An invoice will generate and deliver to your email's inbox with each purchase. Monthly statements are emailed on the 1st of each month and due by the 18th.

  • Company Information

  • Please enter a number greater than or equal to 1.
  • Please select an option
  • Owner Information

  • Including middle initial
  • Can be the same email address as Company Information above
  • Bank References

  • Trade Credit References

  • Additional Information

  • Terms & Conditions

    • If the account is not paid as agreed or if the credit limit is exceeded, the business charge account will be temporarily suspended, unless other arrangements are made with the store owner or authorized representative.
    • Repeated late payments may result in permanently revoking your charge privileges.
    • Payments not received within 30 days of the statement date will receive a service charge of 2%.
    • Invoices are emailed at the time of purchase.
    • Statements are emailed on the 1st of each month and full payment is due within 18 days of statement/on the 18th day of the month. J.W. Niederauer, Inc. will email a statement each month which will show the unpaid balance for merchandise purchased including any monthly finance charge.
    • J.W. Niederauer, Inc. may declare the unpaid balance to be due and payable if you default in making any required payment in full when due, and you agree to pay J.W. Niederauer, Inc. (or its agent) all reasonable collection expenses, attorney's fees and court costs incurred in collecting this account.
    • You must immediately notify J.W. Niederauer, Inc. upon any change in our address or company ownership.
  • I/We certify that all the information on this form is correct. I/we fully understand your credit terms and agree to the proper payment in consideration of extended credit. Furthermore, I/we approve of your obtaining information from the above references and a credit report on my company or if not a corporation, a report on me/us personally. If you update, renew, or extend my line of credit, you may request a new report without notice.