Credit Application - Minneapolis Oxygen

AUTHORIZATION
Name and title*

To induce Minneapolis Oxygen Company to extend a line of credit for purchases under credit sales terms as stated below, we authorize Minneapolis Oxygen Company to contact references and banks listed. We also understand that this information will be held in strict confidence and be used solely for the consideration of credit to us.
Consent*
I agree to the terms
Terms of Credit
All invoices are due 30 days from invoice date, a service charge of 1-1/2% per month will be assessed on all past due accounts, and will be placed on C.O.D.
Consent*
I agree to the Terms of Credit.
I have read the Minneapolis Oxygen Company's Terms of Credit and agree to them.
Name, Title, Date*
Consent*
I agree to the guarantee debts.
I do hereby personally guarantee any and all debts incurred on behalf of the individual or the organization applying for credit.
Name, Title, Date*
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Bank Reference