Customer Credit Application

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Customer Credit Application

Type of Business(Required)
MM slash DD slash YYYY
Business Address(Required)

POC for Invoices

Address for Invoices

Bank Reference Information

Trade Reference 1


Trade Reference 2


Trade Reference 3


Authorization To Release Information

To establish a line of credit, I hereby authorize our trade references and bank to release to Medical Points Abroad, Inc.., all necessary information.

Signature serves as a release to conduct a routine credit check obtaining information from trade references, bank, any party whom customer does business with, and credit reporting agencies. ALL INFORMATION OBTAINED BY MEDICAL POINTS ABROAD, INC , WILL BE HELD CONFIDENTIAL.

The above information is provided for extending credit by Medical Points Abroad, Inc, to our company. To the best of our knowledge and belief, the information is complete and accurate and may be relied upon in making your credit decision. The company agrees to pay all bills when due, including reasonable collection and attorney’s fees, if collection is required.

Personal Guarantee

I/We jointly and severally do hereby agree to personally guarantee, absolutely and unconditionally, the payment of any and all debts incurred by the Purchaser when payment for the goods and services shall become due. It is further understood that this personal guarantee is to apply to any and all goods and services sold to Purchaser during the period beginning with the date of this credit agreement and extending to a time when written notice of the cancellation hereof shall have been received and accepted by the Medical Points Abroad, Inc.. This agreement shall not be waived or otherwise impaired by an extension of time for payment to Purchaser, or by the ceasing of Purchaser to continue to operate.
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