PROPRIETORS, PARTNERS AND OFFICERS

TYPE OF CREDIT REQUESTED

PST TAX REGISTRATION(IF APPLICABLE)

POINTS OF SALE

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TERMS AND CONDITIONS

THE ABOVE INFORMATION IS SUPPLIED FOR THE PURPOSE OF OBTAINING CREDIT AND IS WARRANTED TO BE TRUE. I UNDERSTAND AND CONSENT TO GEMSEN. OBTAINING A CONSUMER REPORT CONTAINING INFORMATION RELATING TO THIS APPLICATION. I FURTHER AGREE THAT SHOULD MY ACCOUNT FALL INTO ARREARS, GEMSEN IS ENTITLED TO WITHDRAW CREDIT PRIVILEGES AT ITS OWN DISCRETION. NSF CHEQUES ARE SUBJECT TO A MINIMUM SERVICE CHARGE OF $25 PER OCCURANCE. THE APPLICANT HEREBY ACKNOWLEDGES RECEIVING A COPY OF THE CREDIT APPLICATION. COMPLETION OF THIS APPLICATION SHALL CONSTITUTE APPROVAL FOR THE RELEASE OF INFORMATION AS PROVIDED FOR BY APPLICABLE PRIVACY LEGISLATION. ALL PAYMENTS ARE DUE ON THE DATE SET OUT ON THE INVOICE. INTEREST SHALL ACCRUE AT 2% PER MONTH (24% PER ANNUM). IN THE EVENT THAT ANY COLLECTION PROCEEDINGS ARE REQUIRED FOR OUTSTANDING INVOICES, ALL COLLECTION COSTS SHALL BE THE RESPONSIBILITY OF THE CUSTOMER. ALL GOODS SHALL REMAIN THE PROPERTY OF GEMSEN UNTIL PAID FOR IN FULL. ALL SHIPMENTS WILL BE SENT COD, FREIGHT COLLECT UNLESS OTHERWISE APPROVED BY GEMSEN. I UNDERSTAND AND AGREE THAT ALL RETURNS ARE SUBJECT TO A 25% RESTOCKING CHARGE AND MUST ACCOMPANY AN APPROVED RETURN AUTHORIZATION NUMBER (RA#) SUPPLIED BY GEMSEN. FOR CORPORATE ACCOUNTS, AND FOR GOOD AND VALUABLE CONSIDERATION ACKNOWLEDGED TO HAVE BEEN RECEIVED BY HIM OR HER, THE UNDERSIGNED HEREBY GUARANTEES THE OBLIGATIONS OF THE CUSTOMER WITH RESEPCT TO PAYMENT OF ALL INVOICES AND BALANCES DUE TO GEMSEN, FROM TIME TO TIME, INCLUDING ALL INTEREST AND COSTS WHICH MAY BE CHARGEABLE ON THE ACCOUNT.

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