Check One Select Credit Application and Agreement - Amazon Web ...
Check One
This section to be completed by a CVA employee. CVA Location: CVA Employee:
Individual Partnership Corporation LLC LLP
Select
Credit Application and Agreement
Agricultural Producer Non-Agricultural Patron
Account # ___________________________
All items MUST be fully completed and application MUST be signed before returning it to Central Valley Ag Full Legal Name: Current Address: City: State: Years/Months at above address: Previous Address (if less than 3 years at current address): City: State: Present Employer: Length of Employment:
Zip:
Zip:
SSN or FEIN: Date of Birth: Phone: ( ) Email address:
-
Years/Months at:
Annual Salary (excluding farming or ranching income):
(if seeking a joint account, include joint applicant's information on second page)
Financial Information: Current Financial Institutions for Loans and Deposits / Contact Person: 1. Account #: Address: 2. Account #: Address:
Phone: Phone:
Credit References: 1. 2.
Address: Address:
Phone: Phone:
List the maximum dollar amount to be purchased in any one month period under convenience credit. 1. Feed / Animal Health
$
4. Grain
$
2. Fertilizer / Chemical / Seed
$
5. Misc.
$
3. Propane / Fuels / Lubes
$
TOTAL
$ (Maximum per one month period)
Note to new Patrons: As a cooperative, Central Valley Ag classifies its patrons as stockholders if they are active agricultural producers or certificate of participation holders if they are non-agricultural patrons. When the Cooperative allocates patronage to new patrons the first time, it will deduct from the cash portion of the patronage ten dollars ($10) which will be used to pay for the face value of the share of common stock or the certification of participation. The remaining non-cash portion of any patronage allocation will be allocated on the books of the Cooperative as Members’ Equity Credits. The undersigned stockholder or patron of Central Valley Ag, York, Nebraska hereby gives consent that the amount of any distribution with respect to its patronage, which are made in qualified written notices of allocation (which means any capital stock, revolving funds, certificates, retain certificate, certificate of indebtedness, letter of advice, or other written notice; which discloses to the patron the stated dollar amount allocated to it and the portion thereof, in any, which constitutes a patronage dividend) and which are r eceived from the Central Valley Ag, York, Nebraska, will be taken into account by stockholder/patron at their stated dollar amounts in the manner provided in the Revenue Act of 1962 in the taxable year in which such wr itten notices of allocation are received by stockholder/patron. I, the undersigned, have read the Credit Agreement and agree to the terms of that agreement and the Consent To Account For Patronage.
I/We authorize Central Valley Ag to make whatever credit inquiries that it deems necessary in connection with this credit application or in the course of review of collection of any credit extended in reliance on the application. I/We authorize and instruct any person or consumer reporting agency to complete and furnish to Central Valley Ag any information it may have or obtain in response to such credit inquiries and agree that such information, along with this application, shall remain Central Valley Ag’s property whether or not credit is extended. I/We further understand that all authorized charges to my/our account are my/our obligations, regardless of personal agreements with other parties, renter or tenants of our land or dwellings, unless they have applied for, received and used their own account for acquiring goods and services. All information set forth in this application is declared to be a true representation to the facts, made for the purpose of obtaining the credit requested and any willful misrepresentation on this application could result in criminal action. Notice: The Federal Equal Credit Opportunity Act prohibits creditors from discrimination against credit applications on the basis of sex or marital status. The Federal agency which compliance with this law concerning this cooperative is: Federal Trade Commission, Denver Regional Office 1405 Curtis Street, Suite 2900 Denver, CO 80202 IF THE CUSTOMER IS A CORPORATION OR OTHER ENTITY, THE PERSON EXECUTING THIS AGREEMENT AGREES TO PERSONALLY GUARANTEE THE PAYMENT OF ALL AMOUNTS DUE FROM THE CUSTOMER TO CENTRAL VALLEY AG. CENTRAL VALLEY AG MAY ALSO REQUIRE A PERSONAL GUARNTEE FROM OTHER INDIVIDUALS AS A CONDITION FOR RECEIVING CREDIT. THE CREDIT AGREEMENT OF CENTRAL VALLEY AG IS INCORPORATED INTO AND A PART OF THIS CREDIT APPLICATION AND AGREEMENT. I/WE ACKNOWLEDGE RECEIPT OF THE CREDIT AGREEMENT OF CENTRAL VALLEY AG AND AGREE TO BE BOUND BY ITS TERMS AND CONDITIONS. I/WE FURTHER ACKNOWLEDGE RECEIPT OF THE REQUIRED FRDERAL DISCLOSURES. I/WE GIVE CENTRAL VALLEY AG PERMISSION TO CONFIRM FINANCING ARRANGEMENTS MADE WITH THE ABOVE LENDING INSTITUTIONS.
Applicant’s Signature: __________________________________________________________________________________
Date: ________________________
Joint Applicant or Guardian: ___________________________________________________________________
Date: _____________________________
Revised: 6/15/2015
Account # __________________________
Joint Applicant Information: (complete ONLY if seeking a joint account and using joint applicant's income for credit consideration) Full Legal Name: Current Address: City: State: Years/Months at above address: Previous Address (if less than 3 years at current address): City: State: Present Employer: Length of Employment:
Zip:
Zip:
SSN or FEIN: Date of Birth: Phone: ( ) Email address:
-
Years/Months at:
Annual Salary (excluding farming or ranching income):
Revised: 6/15/2015
CENTRAL VALLEY AG
Credit Agreement Central Valley Ag, herein after referred to as the “Co-op” offers convenience credit to qualified patrons. Convenience credit should not be construed as a line of credit for long term financing. Patrons using convenience credit must follow the terms of this Credit Agreement and associated policies, applications, agreements, guarantees or forms in order to remain eligible for convenience credit. The Co-op considers the extension of convenience credit as a service to the patrons and not as a right. The Co-op reserves the right to deny or limit the extension of credit to any patron when such denial or limit is in the best interest of the Co-op. Every patron who does business with the Co-op shall be deemed to have agreed to be bound by the provisions of this Credit Agreement. The Credit Agreement of the Co-op is subject to change without prior notice. Upon approval of credit for the Customer, the Co-op will allow the Customer to make purchases of products and services on credit and Customer agrees to pay for the products in accordance with this Agreement. DUE DATE
All purchases on credit will be stated on the monthly invoice statement rendered by the Co-op as of the last business day of the month. The statements are due and payable by the 20th of the month following statement.
DELINQUENCY CHARGE AND INTEREST CHARGE
Any unpaid invoice statement balance or portion thereof not paid by the DUE DATE will be subject to a DELINQUENCY CHARGE of 5% which will be added to the invoice balance. In addition to the Delinquency Charge, an INTEREST CHARGE of 1.33% per month will be assessed on the last day of the month following the statement date on all unpaid balances existing as of that date.
TERMINATION OF CREDIT
The Co-op reserves the right to terminate credit sales at any time without prior notification. No amount of additional sales of products on credit will be allowed if the account has a past due balance more than 45 days following the statement date.
CHANGE IN TERMS
Credit terms may be changed at the discretion of the Co-op including, but not limited to, changing the due date, changing the billing cycle, LIMITING THE AMOUNT OF APPROVED CREDIT, or on any other matter after notice of such change has been given to the Customer.
DISPUTED STATEMENT
All invoices and statements rendered by the Co-op will be conclusive as to the items purchased and charges therefor unless the Customer informs the Co-op in writing of a dispute thereon within 10 days of the statement date.
GUARANTY
If the Customer is a corporation or other entity, the person executing this Agreement, in order to induce the Co-op to grant Credit to the corporation or other entity, hereby agrees to personally guarantee the payment of all amounts due from the Customer to the Co-op. The Cooperative may further require separate personal guarantees from other stockholders, members, partners, whomsoever, in granting credit to a corporation or other entity.
NO WAIVER RIGHTS
Neither an extension of time for payment granted to the Customer, if any, nor acceptance of partial payment by the Co-op, if any, shall constitute a waiver of any right to full payment of all sums due and owing to the Co-op by the Customer.
RIGHT OF OFFSET
Customer agrees that the Co-op may offset and apply any amounts it may from time to time owe the Customer for whatever reason against any unpaid past due credit balance of the Customer.
ADMINISTRATIVE CHARGES
The Co-op may assess a reasonable charge to offset the additional administrative costs incurred by the Co-op when a Customer pays all or a portion of his or her convenience credit account balance by credit card. Such charges shall be added to the Customer’s convenience credit balance prior to completing the credit card payment transaction.
DISPUTE RESOLUTION
This Credit Agreement, including any action to collect past due balances, enforce personal guarantees or litigate product claims for products purchased on credit may be enforced in any Court of competent jurisdiction in the State of Nebraska. Applicant, guarantor and Co-op, to the fullest extent possible waive any claim that the forum is not convenient. Applicant, guarantor and Co-op further, to the fullest extent allowed by law waive their right to a trial by jury.
Applicant agrees that the Co-op may establish other credit terms, require security and participate in shared financing arrangements as it deems necessary in its sole discretion. Adopted by the Board of Directors of Central Valley Ag Cooperative on July 1, 2014.
Applicant’s Signature: ____________________________________________________________________ Date: _____________________
Joint Applicant or Guardian: ________________________________________________________________ Date: _____________________
Revised: 6/15/2015
This section to be completed by a CVA employee. CVA Location: CVA Employee:
Individual Partnership Corporation LLC LLP
Select
Credit Application and Agreement
Agricultural Producer Non-Agricultural Patron
Account # ___________________________
All items MUST be fully completed and application MUST be signed before returning it to Central Valley Ag Full Legal Name: Current Address: City: State: Years/Months at above address: Previous Address (if less than 3 years at current address): City: State: Present Employer: Length of Employment:
Zip:
Zip:
SSN or FEIN: Date of Birth: Phone: ( ) Email address:
-
Years/Months at:
Annual Salary (excluding farming or ranching income):
(if seeking a joint account, include joint applicant's information on second page)
Financial Information: Current Financial Institutions for Loans and Deposits / Contact Person: 1. Account #: Address: 2. Account #: Address:
Phone: Phone:
Credit References: 1. 2.
Address: Address:
Phone: Phone:
List the maximum dollar amount to be purchased in any one month period under convenience credit. 1. Feed / Animal Health
$
4. Grain
$
2. Fertilizer / Chemical / Seed
$
5. Misc.
$
3. Propane / Fuels / Lubes
$
TOTAL
$ (Maximum per one month period)
Note to new Patrons: As a cooperative, Central Valley Ag classifies its patrons as stockholders if they are active agricultural producers or certificate of participation holders if they are non-agricultural patrons. When the Cooperative allocates patronage to new patrons the first time, it will deduct from the cash portion of the patronage ten dollars ($10) which will be used to pay for the face value of the share of common stock or the certification of participation. The remaining non-cash portion of any patronage allocation will be allocated on the books of the Cooperative as Members’ Equity Credits. The undersigned stockholder or patron of Central Valley Ag, York, Nebraska hereby gives consent that the amount of any distribution with respect to its patronage, which are made in qualified written notices of allocation (which means any capital stock, revolving funds, certificates, retain certificate, certificate of indebtedness, letter of advice, or other written notice; which discloses to the patron the stated dollar amount allocated to it and the portion thereof, in any, which constitutes a patronage dividend) and which are r eceived from the Central Valley Ag, York, Nebraska, will be taken into account by stockholder/patron at their stated dollar amounts in the manner provided in the Revenue Act of 1962 in the taxable year in which such wr itten notices of allocation are received by stockholder/patron. I, the undersigned, have read the Credit Agreement and agree to the terms of that agreement and the Consent To Account For Patronage.
I/We authorize Central Valley Ag to make whatever credit inquiries that it deems necessary in connection with this credit application or in the course of review of collection of any credit extended in reliance on the application. I/We authorize and instruct any person or consumer reporting agency to complete and furnish to Central Valley Ag any information it may have or obtain in response to such credit inquiries and agree that such information, along with this application, shall remain Central Valley Ag’s property whether or not credit is extended. I/We further understand that all authorized charges to my/our account are my/our obligations, regardless of personal agreements with other parties, renter or tenants of our land or dwellings, unless they have applied for, received and used their own account for acquiring goods and services. All information set forth in this application is declared to be a true representation to the facts, made for the purpose of obtaining the credit requested and any willful misrepresentation on this application could result in criminal action. Notice: The Federal Equal Credit Opportunity Act prohibits creditors from discrimination against credit applications on the basis of sex or marital status. The Federal agency which compliance with this law concerning this cooperative is: Federal Trade Commission, Denver Regional Office 1405 Curtis Street, Suite 2900 Denver, CO 80202 IF THE CUSTOMER IS A CORPORATION OR OTHER ENTITY, THE PERSON EXECUTING THIS AGREEMENT AGREES TO PERSONALLY GUARANTEE THE PAYMENT OF ALL AMOUNTS DUE FROM THE CUSTOMER TO CENTRAL VALLEY AG. CENTRAL VALLEY AG MAY ALSO REQUIRE A PERSONAL GUARNTEE FROM OTHER INDIVIDUALS AS A CONDITION FOR RECEIVING CREDIT. THE CREDIT AGREEMENT OF CENTRAL VALLEY AG IS INCORPORATED INTO AND A PART OF THIS CREDIT APPLICATION AND AGREEMENT. I/WE ACKNOWLEDGE RECEIPT OF THE CREDIT AGREEMENT OF CENTRAL VALLEY AG AND AGREE TO BE BOUND BY ITS TERMS AND CONDITIONS. I/WE FURTHER ACKNOWLEDGE RECEIPT OF THE REQUIRED FRDERAL DISCLOSURES. I/WE GIVE CENTRAL VALLEY AG PERMISSION TO CONFIRM FINANCING ARRANGEMENTS MADE WITH THE ABOVE LENDING INSTITUTIONS.
Applicant’s Signature: __________________________________________________________________________________
Date: ________________________
Joint Applicant or Guardian: ___________________________________________________________________
Date: _____________________________
Revised: 6/15/2015
Account # __________________________
Joint Applicant Information: (complete ONLY if seeking a joint account and using joint applicant's income for credit consideration) Full Legal Name: Current Address: City: State: Years/Months at above address: Previous Address (if less than 3 years at current address): City: State: Present Employer: Length of Employment:
Zip:
Zip:
SSN or FEIN: Date of Birth: Phone: ( ) Email address:
-
Years/Months at:
Annual Salary (excluding farming or ranching income):
Revised: 6/15/2015
CENTRAL VALLEY AG
Credit Agreement Central Valley Ag, herein after referred to as the “Co-op” offers convenience credit to qualified patrons. Convenience credit should not be construed as a line of credit for long term financing. Patrons using convenience credit must follow the terms of this Credit Agreement and associated policies, applications, agreements, guarantees or forms in order to remain eligible for convenience credit. The Co-op considers the extension of convenience credit as a service to the patrons and not as a right. The Co-op reserves the right to deny or limit the extension of credit to any patron when such denial or limit is in the best interest of the Co-op. Every patron who does business with the Co-op shall be deemed to have agreed to be bound by the provisions of this Credit Agreement. The Credit Agreement of the Co-op is subject to change without prior notice. Upon approval of credit for the Customer, the Co-op will allow the Customer to make purchases of products and services on credit and Customer agrees to pay for the products in accordance with this Agreement. DUE DATE
All purchases on credit will be stated on the monthly invoice statement rendered by the Co-op as of the last business day of the month. The statements are due and payable by the 20th of the month following statement.
DELINQUENCY CHARGE AND INTEREST CHARGE
Any unpaid invoice statement balance or portion thereof not paid by the DUE DATE will be subject to a DELINQUENCY CHARGE of 5% which will be added to the invoice balance. In addition to the Delinquency Charge, an INTEREST CHARGE of 1.33% per month will be assessed on the last day of the month following the statement date on all unpaid balances existing as of that date.
TERMINATION OF CREDIT
The Co-op reserves the right to terminate credit sales at any time without prior notification. No amount of additional sales of products on credit will be allowed if the account has a past due balance more than 45 days following the statement date.
CHANGE IN TERMS
Credit terms may be changed at the discretion of the Co-op including, but not limited to, changing the due date, changing the billing cycle, LIMITING THE AMOUNT OF APPROVED CREDIT, or on any other matter after notice of such change has been given to the Customer.
DISPUTED STATEMENT
All invoices and statements rendered by the Co-op will be conclusive as to the items purchased and charges therefor unless the Customer informs the Co-op in writing of a dispute thereon within 10 days of the statement date.
GUARANTY
If the Customer is a corporation or other entity, the person executing this Agreement, in order to induce the Co-op to grant Credit to the corporation or other entity, hereby agrees to personally guarantee the payment of all amounts due from the Customer to the Co-op. The Cooperative may further require separate personal guarantees from other stockholders, members, partners, whomsoever, in granting credit to a corporation or other entity.
NO WAIVER RIGHTS
Neither an extension of time for payment granted to the Customer, if any, nor acceptance of partial payment by the Co-op, if any, shall constitute a waiver of any right to full payment of all sums due and owing to the Co-op by the Customer.
RIGHT OF OFFSET
Customer agrees that the Co-op may offset and apply any amounts it may from time to time owe the Customer for whatever reason against any unpaid past due credit balance of the Customer.
ADMINISTRATIVE CHARGES
The Co-op may assess a reasonable charge to offset the additional administrative costs incurred by the Co-op when a Customer pays all or a portion of his or her convenience credit account balance by credit card. Such charges shall be added to the Customer’s convenience credit balance prior to completing the credit card payment transaction.
DISPUTE RESOLUTION
This Credit Agreement, including any action to collect past due balances, enforce personal guarantees or litigate product claims for products purchased on credit may be enforced in any Court of competent jurisdiction in the State of Nebraska. Applicant, guarantor and Co-op, to the fullest extent possible waive any claim that the forum is not convenient. Applicant, guarantor and Co-op further, to the fullest extent allowed by law waive their right to a trial by jury.
Applicant agrees that the Co-op may establish other credit terms, require security and participate in shared financing arrangements as it deems necessary in its sole discretion. Adopted by the Board of Directors of Central Valley Ag Cooperative on July 1, 2014.
Applicant’s Signature: ____________________________________________________________________ Date: _____________________
Joint Applicant or Guardian: ________________________________________________________________ Date: _____________________
Revised: 6/15/2015
