THE LIGHTING SOURCE CO., INC.
515 VANDALIA ST. * MEMPHIS, TN  38112
PHONE 901-323-3130 * FAX 901-323-3150 * EMAIL: lightingsource@bellsouth.net
NEW CUSTOMER CREDIT APPLICATION
DATE:______________________
COMPANY: ________________________________________ TYPE OF BUSINESS_________________________
ADDRESS: _____________________________________CITY_______________STATE________ZIP___________
PHONE ____________________  FAX ______________________  EMAIL _________________________________
ACCOUNTS PAYABLE CONTACT _____________________________________ PHONE ____________________
S.S.# / FED ID# _____________________RESALE TAX #___________________(attach tax certificate, or we must charge tax)
TYPE OF ORGANIZATION:_____CORP   _____PARTNERSHIP   _____INDIVIDUAL OWNER   _____LLC
IF INCORPORATED, UNDER STATE LAW OF:__________   DATE INCORPORATED: ______________
OWNER INFORMATION
NAME___________________________________________________TITLE_______________________________
ADDRESS: __________________________________________________________________________________
CITY ____________________   STATE __________   ZIP _______________  PHONE ______________________
BANK INFORMATION
BANK NAME _________________________________________________ACCT# ___________________________
ADDRESS ___________________________________________________FAX # ___________________________
CONTACT ________________________________________________  PHONE # __________________________
TRADE REFERENCES
COMPANY NAME ____________________________________________  CONTACT ________________________
ADDRESS ____________________________________________________________________________________
ACCT#__________________________  PHONE #_______________________  FAX # _______________________
COMPANY NAME ____________________________________________  CONTACT ________________________
ADDRESS ____________________________________________________________________________________
ACCT#__________________________  PHONE #_______________________  FAX # _______________________
COMPANY NAME ____________________________________________  CONTACT ________________________
ADDRESS ____________________________________________________________________________________
ACCT#__________________________  PHONE #_______________________  FAX # _______________________
COMPANY NAME ____________________________________________  CONTACT ________________________
ADDRESS ____________________________________________________________________________________
ACCT#__________________________  PHONE #_______________________  FAX # _______________________
TERMS OF PAYMENT
Terms of payment are net 30 days. If our account is not paid within 45 days, we agree to pay a service charge of 1.5% per month on the balance during the term of delinquency. We authorize you to contact our references for credit information. We agree this account may be placed on COD if payment is not made within forty five days of invoice. Customer agrees to pay all sellers costs and expenses of collection,  including reasonable attorney's fees. In the event of suit, we agree to the venue of the Circuit Court of Shelby County, State of Tennessee.
_______________________________________                                     ________________________
SIGNATURE OF OFFICER                                                                                                                         DATE
_______________________________________                             __________________________________
PRINTED NAME                                                                                                                              TITLE
Has company or any owner ever been bankrupt, refused borrowing, or are there current outstanding liens or judgments or civil actions pending?  ______Yes   ______No   (If yes, attach explanation)
GUARANTY OF INDEBTEDNESS
The undersigned Guarantor, in order to induce The Lighting Source Co., Inc. (TLS) to extend credit to applicant herein, does hereby unconditionally personally guarantee all sums which may be owed by applicant to TLS, whether said indebtedness is due now or hereafter incurred. This Guaranty is continuing, and shall continue to apply to all indebtedness whicj applicant may hereinafter incur, renew, or extend in whole or in part with TLS, all without notice to the undersigned Guarantor TLS may jointly or independently modify the indebtedness, accept or release collateral, or release the applicant , without releasing the undersigned Guarantor, and such release may be done without notice to the other Guarantor. The undersigned Guarantor waives notice of execution of this Guaranty. If it becomed necessary to enforce this guarantee by suit, I agree to pay TLS interest and attorney's fees as allowed by law. In the event of suit, we agree to the venue of the Circuit Court of Shelby County, State of Tennessee.
______________________________________                           ______________________________
SIGNATURE OF GUARANTOR                                                                                                         DATE
______________________________________                           ______________________________
PRINTED NAME                                                                                                                           TITLE