Customer Credit Application

Shareholder(s):

Company Officers:

President:
Vice President
Treasurer
***If Yes, forward a copy of your Sales Tax Exemption Certificate with this application or sales tax will be charged. For establishing credit terms with WATERLUX, LLC DBA Aquaphor USA, the above applicant furnishes the following bank references and trade references, and authorizes the release of information regarding the applicant by these organizations to WATERLUX, LLC DBA Aquaphor USA.

Bank Reference

Trade References

IMPORTANT NOTICES:

The undersigned hereby make application to WATERLUX, LLC DBA Aquaphor USA for a credit account and by doing so authorizes WATERLUX, LLC DBA Aquaphor USA, in connection with the establishment and maintenance of this account, to investigate the applicant’s credit worthiness and capacity. The undersigned warrants the foregoing answers are true and accurate in every respect. Purchaser agrees that title to the merchandise is reserved by and remains vested in WATERLUX, LLC DBA Aquaphor USA until the purchase price is paid in full. If purchaser fails to pay any part of the purchase price in full when due, WATERLUX, LLC DBA Aquaphor USA may take possession of said merchandise without notice or liability to purchaser. This application must be completed in full to establish credit terms. It is understood that payment is due 30 days from date of Invoice. A 1.5% monthly (18% APR) service charge may be added to all delinquent accounts. If delinquent payment makes placement for collection necessary, customer will be responsible for all collection expenses as well as reasonable attorney fees and court costs incurred by WATERLUX, LLC DBA Aquaphor USA. My signature below indicates that I understand, accept, and will comply with these terms and allow WATERLUX, LLC DBA Aquaphor USA to perform a credit investigation.

Officer Signature & Title (required to process application)

THIS PORTION IS REQUIRED FOR SOLE PROPRIETORS AND PARTNERSHIPS ONLY

In consideration of credit being extended by WATERLUX, LLC DBA Aquaphor USA, to the above named applicant for merchandise to be purchased whether applicant be an individual or individuals, a proprietorship, a partnership, a corporation, or other entity, the undersigned guarantor or guarantors each hereby contract and guarantee to WATERLUX, LLC DBA Aquaphor USA the faithful payment, when due, of all accounts of said applicant for the purchases made. The undersigned guarantor or guarantors each hereby expressly waive all notice of acceptance of this guarantee, notice of extension of credit to applicant, presentment and demand for payment on applicant, protest and notice to undersigned guarantor or guarantors of dishonor or default by applicant or with respect to any security held by WATERLUX, LLC DBA Aquaphor USA extension of time of payment to applicant, acceptance of partial payment or partial compromises, all other notices to which the undersigned guarantor or guarantors might otherwise be entitled and demand for payment under this guarantee. Absent written permission by WATERLUX, LLC DBA Aquaphor USA, this personal guarantee may not be revoked.

The following information pertains to invoicing options and payment options – PLEASE COMPLETE

Please provide the email address for invoices below:

Please remit all payments to:

WATERLUX, LLC DBA Aquaphor USA 290 SW 12th AVE STE 3 Pompano Beach, FL 33069

If you pay via wire transfer or ACH, please list the contact name and phone number below to set up the bank information for the transfer.

If you have any questions, please contact Katerina Dreval at 754-317-0104 aquaphor@waterlux.com