Application for Purchasing


Company Name:



Shipping Address:

City, State, Zip:

Mailing Address:

Business Phone#:



Home Address:

Cell Phone#:

City, State, Zip:

Authorized Buyers:

Authorized Buyers:

Bank Reference:

Bank Phone#

LA Tax #

Soc. Sec #:

Business Operates as: (Circle One)

Corporation Partnership Proprietorship

Type of Business: (Circle One)

Florist Gift Shop Interior Designer Nursery Other (Specify)_________________


All Invoices are payable in full by the 10th of the month following purchases and become delinquent on the 16th of the month following the purchase. A Late charge of $5.00 per $100 will be assessed on any balance due remaining unpaid on the 16th following purchase. On any check returned by the bank due to insufficient funds, there will be a charge assessed in the amount of $20.00 per check or 5% of the face amount of the check, whichever is greater. Credit purchases will be stopped if and when account becomes 60 days past due. Payment on credit accounts must be made by check or cash. Although credit cards will be accepted as payment at the point and time of the sale, as an alternative to Louisiana Wholesale Florists, Inc., credit account, credit cards will NOT be accepted as payment on account. The applicant also agrees to pay all costs associated with collection, such as attorney's fees, of the past due indebtedness.

I have read, understand, and accept the above terms, and have provided true information to the best of my knowledge. I further authorize Louisiana Wholesale Florist, Inc., to verify any and all references we have been given that may be required to determine our credit capabilities and to request relevant information from credit reporting agencies. Signature:_______________________________________________________________


In consideration of any credit extended, I (we, either of us) will individually and/or jointly guarantee full and prompt payment of all indebtedness by FIRM NAME:___________________________________ incurred for merchandise furnished by Louisiana Wholesale Florists, Inc., plus service charges and collection costs where applicable. Such guarantee shall remain in force until its revocation is acknowledged in writing to Louisiana Wholesale Florists, Inc. Such revocation shall not affect indebtedness incurred prior to receipt of written notice.
Signature:____________________________________________________ Title:_________________________
Signature:____________________________________________________ Title:_________________________
Click on the link to print and fill in your LA Sales Tax Exemption Form.  Please submit this form with your credit application to avoid having to pay LA sales taxes on your purchases.



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