New Account & Credit Application

We appreciate the opportunity to serve you and your professional finishing 
needs.  Please complete the information contained herein to establish an open 
account status with NCTCI.

Company Name: ____________________________  Date: ________________
Owner name: ____________________  Telephone #:	 _____________________
Street Address: ___________________ City: _______________ State: _______
   Zip:_________________
Person to Contact: ________________ Years in Business: _________________
Have you ever declared bankruptcy? _____________ If so, when? ___________
Estimated monthly lab bill? __________ Credit Limit Requested? ____________

Please select the payment option you are applying for:
o	Open Account Statement by the end of the month pay by 15th
o	Credit card with each days orders/invoices
o	Credit Card charges at the end of the month per statement
o	Pay when picking up

Please list three references.  References must include one bank with account 
number, one credit card number with expiration date and one reference of your 
choice.  Please include name, address and telephone number.

1._______________________________________________________________

2._______________________________________________________________

3._______________________________________________________________

All photographers who do not have a Certificate if Resale (From E-595-E) 
on file at NCTCI will be charged North Carolina Sales Tax on all purchases.

In consideration of extending credit by NC TriColor Imaging, Inc (seller), Buyer agrees to pay balance shown 
on monthly billing statement rendered by Seller upon receipt of such statement.  If the amount shown as 
new balance is not paid in full before the closing of the next monthly statement, Seller may add a 
delinquency assessment to such balance which Buyer agrees to pay.  The delinquency assessment will be a 
FINANCE CHARGE of 1 ˝% applied to the unpaid monthly balance, which is an ANNUL PERCENTAGE 
RATE of 18%.  If the Buyer fails to make any payment when due, Seller may declare the full remaining 
balance immediately due and payable.  The Buyer agrees to pay court costs and reasonable attorney’s fees 
if the account is referred for collections to an attorney who is not a salaried employee of the Seller.  By 
signing this application, you the Buyer, hereby authorize the Seller to charge any account balance on your 
credit card number you have provided, if it is not paid in full by the monthly due date.  Upon charging the 
balance of your account to your provided credit card number if the card is declined for any reason you will be 
placed on a cash only basis and payment will be due at the time of pickup.  I the Buyer, by signing below 
accept personal responsibility for any and all debt created by the above company.

Signature of Owner: _____________________________ Date: ____________