United Maxon Inc.

We appreciate the opportunity of serving you. To open as a net account, we are outlining the following information to enable us to accommodate your needs. Please fill out completely.
Dealers Application:
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List Proprietors, Partners or Corporation offices' information:
Owener#1
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Owener#2
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Owener#3
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List three trade references:
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List bank information with account #:
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Customer Agreement: I agree to following terms and conditions by acceptance of merchandise on an invoice, Claims for errors must be made upon receipt of goods. Returned goods are subject of a 15% restocking charge. No returns allowed 15 days after date of invoice. A 1-1/2% per month interest charge or a $15.00 late charge will be assessed on all N. S. F. checks or past due invoices (18% annually.) Plus collection of attorney fees if legal action is taken.
Signature :
Title:
Date:
Print Name :
104 Exchange PI. Pomona, CA 91768, USA
Phone(909) 869-7977 Fax: (909)595-8600 E-mail: ScubaMax2@aol.com