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Credit Application
(Adobe Acrobat Reader Adobe Acrobat version)

Please complete these fields, then click "Print Form" at the bottom of this page.
We require telephone numbers and fax numbers on all applications.

 FIRM
Company Name
dba
Type of Business Individual Corporation Partnership
Billing Address
City  State Zip
Shipping Address
City  State Zip
Contact Person
Phone Fax
Email Address
Accounts Payable
Phone Fax
Email Address
       
 BANK REFERENCE
Name
City  State Zip
Phone Fax
Account # Branch
       
 TRADE REFERENCES
1. Name
City  State Zip
Phone Fax
2. Name
City  State Zip
Phone Fax
3. Name
City  State Zip
Phone Fax
4. Name
City  State Zip
Phone Fax
       
 TERMS
A. Full payment of invoice is due no later than 30 days from the date on invoice. Amounts overdue (net 30) will be subject to a late payment charge of 1.5% per month.
B. Applicant understands that LRI will make our usual credit investigation and authorizes applicant's bank to release information which may include consumer and/or commercial credit report as needed by LRI.
C. Should it become 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 by the applicant.
D. The undersigned agrees that all credit extended by LRI, shall be deemed subject to the terms agreed herein, and all invoices are payable and due.

LRI is committed to always providing the brightest, highest quality LED products on the market. From time to time we upgrade and improve our products with in-line changes. These changes are not always announced publicly as we feel it is our duty to simply provide our customers the highest quality Micro Light on Earth.

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