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New Account Form

Credit Application Form

Name Title Address Phone
Name Address Phone

I hereby personally guarantee THE HOSE SHOP, INC. payment of any obligation of the company and hereby agree to bind ourselves to pay you on demand any sum which may become due to you by the company, whenever the company shall fail to pay same. It is understood that this guarantee shall be a continuing and irrevocable guarantee and indemnity for non-payment and notice thereof and consent to any modification or renewal of the credit agreement hereby guarantee. We certify that all of the information on this form is correct. We fully understand your credit terms as "NET 30 DAYS" and agree to the proper payment thereof in consideration of extended credit.


To sign, please enter your full name.

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