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To apply for credit with Air & Hydraulic Supplies please complete the application form below.

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Company Information:

Principles of the Company:

Trade References (5 Required):

Banking Information

In consideration of Air & Hydraulic Supplies Inc. granting credit to my company, I/We understand
that the payment is due in 30 days from date of the invoice. I/We agree to pay a service charge
of the maximum rate in the industry for all past due invoices exceeding 30 days and agree to pay all
reasonable legal and/or collection fees incurred by Air & Hydraulic Supplies Inc. to secure payment
for any past due amounts.

I/We hereby declare that the enclosed credit information is true and accurate to the best of my/our
knowledge and belief. I/We hereby authorize any institution herein listed as a credit reference, bank
or trade reference to release credit information concerning myself and/or the company I/We represent
to Air & Hydraulic Supplies Inc. This authorization is given to enable Air & Hydraulic Supplies Inc. to
promptly and fairly evaluate my/our request for credit. In order to facilitate possible future requests
for credit from Air & Hydraulic Supplies Inc. or from other creditors, I/We further authorize Air &
Hydraulic Supplies Inc. to disclose factual information regarding the record of payments on our

Please check this box to accept the terms