3962 Portland Street, Coplay, PA 18037 1216 Illinois Avenue, South Houston, TX 77587 1859 Lindbergh St. Suite 100 Charlotte, NC 28208

             Tel: 610.261.1900   1.800.346.5368                               Tel: 713.943.1818   1.800.338.4239                                           Tel: 704.398.3123   7.800.924.4092           

                             Fax: 610.261.0744                                                                Fax: 713.943.7773                                                                            Fax: 704.398.3454

  New Account Information & Credit Application

Company Name & Billing Address:            Shipping Address:




Phone:                               Business open date:

Fax:                              Corporation:                             Individual:

Contact Name:         Federal ID#:

Purchasing E-mail address:     Sales Tax Exempt:

                                                                                                Sales tax number:

Trade References:

Name:      Name:

Fax:  ACCT. #:        Fax:  ACCT. #:

Name:      Name:

Fax:  ACCT. #:        Fax:  ACCT. #:


Line of Credit Required:

Applicant agrees that extension of credit by the seller shall be subject to

and in consideration of the following:

   I.      Terms are that which are stated on the invoices. All amounts are due in accordance with said stated terms.

   II.      Past due balances are subject to service charge of a maximum permitted by state law and so stated on invoices.

   III.      Should it be necessary to assign the account balance to a licensed collection agency or attorney for legal

action, all subsequent collection charges and legal fees shall be paid for by the applicant.

   IV.      The undersigned agrees to the terms and conditions stated herein.

   V.      The undersigned hereby authorizes the above-mentioned companies to release the information requested by

Inweld corporation.

   VI.      Minimum order is $100.00; all orders under said amount will be subject to a $15.00 handling fee.


Signed:        Dated:          Title:
***by typing your signature above you understand that this is your electronic signature and allow the above company to treat it as one.

***Please return with copy of your resale certificate. ***