the robert allen group - Robert Allen Design

the robert allen group - Robert Allen Design

Account Application/Update 2 Hampshire Street, Suite 300 / Foxboro, MA 02035 / Toll Free 1.800.333.3776 / Fax 508.337.7923 Email completed & Signed Cr...

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Account Application/Update 2 Hampshire Street, Suite 300 / Foxboro, MA 02035 / Toll Free 1.800.333.3776 / Fax 508.337.7923 Email completed & Signed Credit Application documents to New Accounts: [email protected]

***If applying for Credit Card terms please complete page 1 only*** Fabric: Preferred Selling Terms COD

Credit Card

Pro Forma (Cash Before Delivery)

For Internal Use

Open Net 30

Account Number What is your Annual Projected Sales Volume with Robert Allen?

$ New

Update

Furniture: Preferred Selling Terms Territory No. Delivery by authorized Robert Allen | Beacon Hill Receiver: 50% deposit and balance paid prior to delivery. Customer Code Delivery by non-authorized Robert Allen | Beacon Hill Receiver: 100% due at time of order. Source of Application: Customer Corp Shw

Company Type Corporation

LLC

Sole Owner Agent Shw

State of Incorporation

Federal ID Number

Date Present Management in Control

Corporate Name

Subsidiary or Division of

Mailing Address

City

( ) Phone

( Fax

State

Zip Code

State

Zip Code

E-Mail

City ( Fax

Segmentation Code:

)

Shipping Address, if different ( ) Phone

Sales Rep

) E-Mail

Authorized Officer or Owner(s): Sole Proprietorships and Partnerships please include social security number(s)

Name

Title

Social Security Number

Name

Title

Social Security Number

Signature:_______________________________ Date:_______________

Signature:_________________________________Date: ___________

Principle Buyer/Purchaser: Name___________________________________e-mail__________________________________________

Please Help Us To Better Serve Your Business Needs: What % of your business is:

Residential

%

Commercial

%

Which of the following options best describes your business (please choose only one)? Interior Designer Workroom

Interior Designer with Storefront

Retailer

How do you mostly shop for fabrics: Your Own Fabric Library

Buyer/Purchasing Agent

Designer Showroom

If you have your own library does it consist of: Less than 25 fabric books

Web

Specifier

Local Rep

Greater than 25 books

How many designers including yourself, do you have on staff? ________ How many projects do you work on each year? _____________________ What % of your fabric purchases are greater than $60 per yard (wholesale)? _______ and how much do you spend per year on fabric: $______________ How did you hear about Robert Allen? Local Sales Rep Search Blog Social Media

Local Showroom

1

Design School

Print Magazine

Online

Rev 03/13

Bank Reference and Authorization

Bank Name

Account Number

Mailing Address ( ) Phone

Bank Officer

City ( Fax

State

Zip Code

) E-Mail

I authorize the above bank to release our balances, security, loan information, ratings, credit lines, and any other information in order to establish credit and or update my account with The Robert Allen Group. X Duly Authorized Signature

Title

Date

Credit References

Business Name

Account Number

Street Address ( ) Phone

City ( Fax

State

Zip Code

State

Zip Code

E-Mail

Account Number

Street Address

City ( Fax

) E-Mail

Business Name

Account Number

Street Address ( ) Phone

Zip Code

)

Business Name

( ) Phone

State

City ( Fax

) E-Mail

Terms and Conditions I agree to pay all debts incurred within terms. Should the debt become past-due, I agree to pay finance charges at the rate of 1 ½ % per month (18% annual rate), or the maximum rate of interest allowed by law, whichever is less. I further agree to pay reasonable collection costs and/or attorney fees incurred in connection with the collection of this account. In addition the undersigned further agrees that neither I nor my company shall have any ownership rights, title or interest in any sample books, galleries, banners or other sampling materials provided to me by The Robert Allen Group, and that upon request, I will promptly deliver them as instructed. My duly authorized signature gives The Robert Allen Group written authorization to update the current condition of my account with all existing and future creditors, lending institutions, or any other credit reporting agency to release any pertinent information in order to establish credit or update credit reference or account information. The Robert Allen Group’s Standard Terms and Conditions of Sale shall govern the transactions of the parties with respect to sales of products to the undersigned. Other than specific fabric descriptions, quantity or delivery terms, no additional or contrary terms or conditions contained in the undersigned’s purchase order(s) shall be of any force or effect, even if the undersigned requires an authorized representative of The Robert Allen Group to sign such purchase order(s) as a condition to obtaining payment. A complete version of our Terms & Conditions is available on our web site robertallendesign.com. When you register with The Robert Allen Group, you give us your consent to process and use the submitted personal data to communicate with you about your order and to keep you informed of our special events or promotions.

This application must be signed to be processed. See other signatures required above for Bank Authorization.

X Duly Authorized Signature

Print Name

Title (Sole Owner/Partner or Officer)

Social Security Number

Date

Resale Tax Certificate(s) and Workroom Declaration(s) The Robert Allen Group is required to tax all shipments unless a completed tax form is on file. If your order is being shipped outside your home state, a completed Workroom Declaration Form may also be required. Do you require a Statement each month?

Yes

No

Please assist us in processing your application quickly by providing all the information requested. Applications must be signed to be processed.

**** PLEASE NOTE THAT ALL INVOICES WILL BE E-MAILED TO YOU UNLESS OTHERWISE REQUESTED BY YOU **** 2

Rev 03/13