RETAILER ONBOARDING

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Master Account

LEGAL BUSINESS INFORMATION - MASTER ACCOUNT


If different from above







INCORPORATION SPECIFIC


OWNER / OFFICER / MAIN CONTACT 





For valuable consideration received, the undersigned personally guaranties payment and performance of all obligations, past, present and future of the above-named business, owing to NCD including any and all finance charges, cost of collection and reasonable attorney's fees in the amount not less that 33 1/3 percent. The undersigned waives presentment, demand, protest and any other notice regarding this Guaranty of Payment. The undersigned hereby submits his/her/itself to the personal jurisdiction of choosing of NCD and waives all rights to trial by jury. 






MUST PROVIDE A VALID AND CLEAR COPY OF STATE ISSUED ID (IE. DRIVERS LICENSE)
OTHER GUARANTOR'S PERSONAL INFORMATION 










MUST PROVIDE A VALID AND CLEAR COPY OF STATE ISSUED ID (IE. DRIVERS LICENSE)
For valuable consideration received, the undersigned personally guaranties payment and performance of all obligations, past, present and future of the above-named business, owing to NCD including any and all finance charges, cost of collection and reasonable attorney's fees in the amount not less that 33 1/3 percent. The undersigned waives presentment, demand, protest and any other notice regarding this Guaranty of Payment. The undersigned hereby submits his/her/itself to the personal jurisdiction of choosing of NCD and waives all rights to trial by jury. 

THIS FIELD ENTRY IS AN EXECUTABLE SIGNATURE

REQUIRED BUSINESS FORM 

MASTER ACCOUNT BANK REFERENCE











EFT INFORMATION












FOR CONFIRMATIONS AND OTHER BANKING COMMUNICATIONS

must upload a voided check image if 'checking account' is selected

CHECK BOX TO VALIDATE

LOCATION SPECIFIC

NOW WE NEED LOCATION SPECIFIC INFORMATION IN ORDER TO SET EACH PROPERTY UP WITH A CUSTOMER NUMBER.
LEGAL BUSINESS INFORMATION - LOCATION SPECIFIC BUSINESS DETAILS


If different from above







MAIN CONTACT 




LICENSES & STATE BUSINESS INFORMATION
INCORPORATION SPECIFIC


LOCATION SPECIFIC
STATE RESALE TEMPLATE FORMS SUPPLIED IF YOU DON'T HAVE

Download, fill out, then upload completed
IF YOU DO NOT HAVE A COPY TO UPLOAD.

BUSINESS LICENSE + TAX INFO

See above for your state's documentation/templates if you need them


CIGARETTE LICENSE INFORMATION - LOCATION SPECIFIC




FINANCIAL INFORMATION
CREDIT CARD AUTHORIZATION






CHECK BOX TO VALIDATE
To add another location please click "add another response" below

Credit Terms / Info

TERMS & CONDITIONS

 

NOTE: Initial orders are C.O.D. CASH unless approved in advance by the credit department and completely signed.

 

       A late penalty per month may be assessed on any unpaid balance that is overdue according to the terms approved by the credit department.

       A returned check charge/service fee will be assessed to your account for any returned check, EFT or insufficient funds of any kind.

       We reserve the right to charge a restocking fee and a money pick-up fee (i.e. picking up money without delivery).

       The Guarantor must notify NCD in writing by certified mail return receipt requested no later than thirty days prior to transfer of ownership of the Guarantor. In the event that the Guarantor breaches his/her/its obligations under this paragraph, the Guarantor and the new owner shall be jointly and severally liable to NCD for all balances due and owing from the time of transfer. In no event may the balances due and owing from the Guarantor be transferred to any other person or entity without the express written consent of NCD, which may be withheld at NCD's discretion.

       In the event of default, NCD is hereby granted the rights to reclaim all goods, including inventory and/or equipment sold by it to our company pursuant to a security interest in such goods, which is herby granted to NCD. The security interest being granted to NCD is in all inventories, equipment, instruments, general intangibles, accounts and all other personal property and goods of every kind and nature. Furthermore, NCD is hereby granted a purchase money security interest in the goods sold by it to Customer, including inventory and equipment. The security interest herein granted shall secure the purchase price of all obligations of Customer due to NCD, including costs of collection and attorney's fees in the amount not less than 33 1/3 percent. Customer irrevocably authorizes NCD at any time and from time-to-time to file in any Uniform Commercial Code jurisdiction, financing statements and amendments thereto. Customer grants NCD an irrevocable limited power of attorney for the purpose of executing and/or recording any and all documents to perfect NCD security interest. NCD is hereby granted all the rights and remedies provided to secured parties under Article 9 of the Uniform Commercial Code as enacted in the jurisdiction of NCD's choosing. The customer waives all rights to trial by jury.

       I authorize National Convenience Distributors, Inc. ("NCD") to contact any reference given herein and any other credit-reporting agency in order to exchange information regarding this credit application.

 

       Counterpart Execution and Use of Photocopies: This Agreement may be executed by signature of the parties to this agreement, or their authorized representatives, on multiple copies of the agreement, including signatures captured digitally as well as copies transmitted by e-mail, portable document format (PDF) or facsimile, and upon being so executed, shall be effective as if all signatures appeared on the original of this agreement. A signed copy agreement shall have the same force and effect as an original.

I, Guarantor/Principal, have fully read and accept of the above "Terms and Conditions".


THIS FIELD ENTRY IS AN EXECUTABLE SIGNATURE