Credit Application

Bank Information

Bank Name

Bank Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Contact Name

First

Last

Role

Contact Phone

Contact Email

Credit References

#1: Company Name

Contact Name

Phone

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

#2: Company Name

Contact Name

Phone

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

#3: Company Name

Contact Name

Phone

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Name Contact Email

Application Agreement

Terms: 15 days net. All accounts past due will be charged 2% per month.

Applicant hereby authorizes the above parties to disclose all requested information regarding their credit history with applicant to Switch Energy Inc.

I/we agree to pay all attorney fees and/or court costs incurred by Switch Energy Inc. in the event legal action becomes necessary to collect any outstanding/overdue balances.

I do hereby state that the information given is correct and that I am from of the firm applying for credit with Switch Energy Inc. and that I am authorized to make this application and that I have read the above and agree to the terms stated.

Your Name

Acts as a Digital Signature

I agree that typing my name serves as my digital signature for this agreement.

Agree

Today's Date

Your Role

Credit Application

Company Information

Bank Information

Credit References

Application Agreement