Billing Company Name
Billing Address 1
Billing Address 2
Billing City
Billing State
Billing Postal Code
Billing Country
Billing Phone
Billing Email
AP Contact First Name
AP Contact Last Name
AP Contact Email
AP Contact Phone
Ship to Company Name
Ship to First Name
Ship to Last Name
Shipping Address 1
Shipping Address 2
Shipping City
Shipping State
Shipping Postal Code
Shipping Country
Shipping Contact Phone
Shipping Contact Email
Please list your additional ship to addresses: (Include Ship to Company, Address, Contact Name, Email and Phone Number for each additional ship to companies)
IMPORTANT: If your business is tax exempt or resale, please provide tax exempt certificate or resale certificate that cover each ship-to location.
If you have multiple locations, it may be easiest to send a multijurisdictional certificate listing all locations.
Please note that we are required to charge sales tax unless we receive the proper exemption certificates before invoicing.
Tax Exempt or resale exemption or resale certificate
Customers outside of the United States, need to provide broker Information
Broker Company Name
Broker Contact Name
Broker Address
Broker City, State, Postal Code, Country
Broker Phone Number
Broker Email
Company's Account Number
Exodus Global and our companies invite you to complete our credit application, once approved it will provide you payment terms.
If the credit application is not completed, payment in full will be due prior to shipment of order
Please note that if you select no that you will be on prepaid terms, meaning payment is required before your order can be shipped.
Please upload your company's credit reference document
Owners/Officers
Trade References (Firms currently extending credit)
Trade Reference 1 - Name
Trade Reference 1 - Address
Trade Reference 1 - Phone
Trade Reference 1 - Email
Trade Reference 1 - City, State, Postal Code
Trade Reference 2 - Name
Trade Reference 2 - Address
Trade Reference 2 - Phone
Trade Reference 2 - Email
Trade Reference 2 - City, State, Postal Code
Trade Reference 3 - Name
Trade Reference 3 - Address
Trade Reference 3 - Phone
Trade Reference 3 - Email
Trade Reference 3 - City, State, Postal Code
Bank Reference
Bank Name
Bank Contact Name
Bank Address
Bank Phone
Bank City, State, Zip Code
We hereby apply for credit and confirm financial responsibility, ability and willingness to pay all invoices in agreement with these terms. The above information is warranted to be true and complete. We hereby authorize Exodus Global and its companies, BladeCore, Connect Work Tools, OilQuick Americas, RockZone Americas, and ShearCore, to verify and collect information on our company including but not limited to bank references. We also authorize these references to provide the requested information to Exodus Global and their companies without cost or obligation. In the event of default, we agree to pay all costs of collection and litigation regarding our account in accordance with the State of Wisconsin. All N.S.F checks will be subject to a $10.00 handling charge.
**INCOMPLETE APPLICATIONS CANNOT BE PROCESSED**
First Name
Last Name
Title
Date
Your Phone Number
Your Email
Form Completed By:
Title
Your Email
Date Completed
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