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APPLICATION FOR CREDIT
Check all that apply:
BROADCAST/ONAIR
ONLINE
Business Name (Formal or Legal)
Other Business or Trade Names(s) Used
Business Address
Telephone
Fax
Contact Name for Payments
Date Firm Established
Annual Sales
Public Company?
Yes
No
Applicant is a:(check one)
Advertising Agency
In-House Agency
Buying Service
Advertiser
.com
Federal Tax ID#
Duns ID#
Web Address:
Email Address:
Estimated Initial Advertising Expenditure
Flight Dates
Advertiser
Product
C24TV Networks Contact Name
Business Entity Type (check one)
Corporation
Partnership
Proprietorship
Limited Liability Company
Bank Reference
Bank Name Account # Address City State Phone
Bank Name Account # Address City State Phone
Credit References (At Least Three Should Be Media)
Name\ Address\ City \ State\ Telephone\ Last Purchase Date
Name\ Address\ City \ State\ Telephone\ Last Purchase Date
Name\ Address\ City \ State\ Telephone\ Last Purchase Date
AGREEMENT TO TERMS:
All of the undersigned represent and warrant that all information contained herein is true and correct. 1) Joint & Several Liability Clause: Notwithstanding to whom bills are rendered, Advertiser, Agency and Service jointly and severally, shall remain obligated to pay C24TV™ the amount of any bills rendered by C24TV™ within the time specified and until payment in full is received by C24TV™. Payment to Agency or to Service or Payment by Agency to Service shall not constitute payment to C24TV™. 2)A credit investigation is required and will take approximately Five (5) business days. If credit is not approved, or if the credit investigation cannot be completed prior to the schedules start date, cash in advance will be required. 3)Payment is due on or prior to Thirty (30) days from the date of invoice. Cash in advance maybe required if your account falls Sixty (60) days past due. I the undersigned am a principal, officer or proprietor of above named company and am authorized to release payments for advertising schedules. I have read the Terms printed above and agree to comply with all such terms.
