Alberto's Truck Repair Merchant Account

Address: 11611 Westminster Ave, Garden Grove, CA 92843
Email Address: service@albertostruckrepairs.com
Phone: 714-756-7491

Business Info:

Name of Corporation

DBA name

Social Security or EIN number

Place of Business

Company Phone Number

Company Email Address

Owner Name

Owner's Address

Owner Phone Number

Banking Information:

Name of Institution

Account #

Type

Checking Saving Loan

Branch Location

Contact Name

Phone

Business References:

Name

Phone Number

Name

Phone Number

Name

Phone Number

(By signing below I hereby authorize the banks and references to release financial and credit information concerning my/our accounts to Alberto’s Truck Repair.)

In consideration of being allowed the privilege of being a charge account, the undersigned hereby agrees to abide by all the terms and conditions of the service agreement and to make the payment thirty days from receiving the invoice. A finance charge of 3% or thirty-five dollars on all outstanding balances past thirty days past due until paid in full. An account will then have 15 net days to pay if failure to pay. An account with a balance of sixty days past due shall be subjected towards a cash on delivery basis. In the event of a non-payment, the undersigned does hereby agree to pay in addition to the principal amount due, reasonable attorney’s fee, and court cost. Alberto’s Truck Repair reserves the right to modify or cancel this credit card authorization at any time.

Firm’s Name

Signature

Print Signature

Date

Alberto's Truck Repair Merchant Account

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