CARPET FABRIC WALLCOVERING FURNITURE CONFIDENTIAL ACCOUNT APPLICATION ALL NEW ACCOUNTS ARE PROFORMA ACCOUNTS 979 Third Avenue New York, NY 10022 Credit Department Tel 212-752-9000 Ext. 7136. Faxit 718-784-0731 COMPANY INFORMATION Company Name Ji SC Th 7 i Contact } AMA Years in Business of al Billing Address 5F5 Lenton Ave , 4® Flan City Vy State Zip 022 Bank Reference BAAC Account Bank Contact Type of Business: \yInterior Designer ¢ © Architect e © Specifier ¢ [ Purchasing Agent ¢ L Hospitality e [| Contract ¢ Other Dun & Bradstreet# OWNER INFORMATION (Must be completed for all partnerships and sole proprietorships) Check One: [ Corporatione §LLC e [) Partnership e [ Sole Proprietorship ¢ Owners Full Name Jun ONO SK, GNOJA SS# Federal ID # Owners Address > ‘a e City Al Y State Zip (08. Partners Full Name ( If Partnership ) SS# Partners Address City State Zip TRADE REFERENCES 1. Name tyraton y/ Lin Py Phone Account# Address City State Zip 2. Name Phone -b ~Fob 8 Account# Address City State Zip 3, Name Phone Account# Address City State Zip | authorize Stark Carpet Corp, to co interest at a rate of 1 4% per mo my failure to pay any unpaid bal; interest and fees by said firm in/the to the terms and conditions. 4 any of my references as well as my banking, business and consumer reporting agencies in order to establish credit terms. | agree to pay % per annum) for all pnpgid past due invoices. | also agree to pay reasonable costs of collection, including attomey's fees, in the event of n consideration of th¢ reéeipt of goods and services by said firm, the undersigned do contractually and personally guarantee all payments, ghy unpaid balances. | have read and understand these terms set forth within this account application and fully agree Authorized Signature Office Use Only Carpet Salesperson#: Account # Entered By Branch Date 979 Third Avenue New York, NY 10022 © T 718-683-5100 Ext# 7136 e F 718-784-0731 « © NE © voww.starkcarpet.com @ 1102014 EFTA00525201

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