Name of Prinicipal *

First Name

Last Name

Business Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Business Phone *

(###)

###

####

Has applicant or any of the company's principal(s) ever files a voluntary petition for bankrupcy? *

No

Yes

Has a tax lien or civil suit been filed against applicant within the last 6 years? *

No

Yes

Dedicated Ship To Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Ship To Phone *

(###)

###

####

Name 1

First Name

Last Name

Phone 1

(###)

###

####

Responsibilities 1

(check all that apply)

Ordering

Shipping

Accounting

Name 2

First Name

Last Name

Phone 2

(###)

###

####

Responsibilities 2

(check all that apply)

Ordering

Shipping

Accounting

Broadleaf Shutter Sample Bag - $150 *

I agree to receive and pay for one sample bag

Anabelle Roller Shade Sample Book - $125 *

I agree to receive and pay for one sample book

Bella Blind Sample - $31 *

I agree to receive and pay for one sample

Juliet Cellular Sample - $35 *

I agree to receive and pay for one sample

I Hereby Certify *

This certificate is for the purchase from Elegant Windows, Inc. of Window Coverings and Related Items. I will resell Window Coverings and Related Items, which I am purchasing under this resale certificate in the form of tangible personal property in the regular course of my business operations, and I will do so prior to making any use of the item(s) other than demonstration and display while holding the item(s) for sale in the regular course of my business. I understand that if I use the item(s) purchased under this certificate in any manner other than as just described, I will owe use tax based on each item’s purchase price or as otherwise provided by law.

I warrant that the above conditions have been carefully read and hereby agree to and certify them.

Please review and acknowledge the following terms *

Applicant, the undersigned, certifies that all of the information on this application is true and complete to the best of Applicant's knowledge and that Applicant withheld nothing which, if disclosed, would alter the integrity of this application. Applicant authorizes Elegant Windows, Inc. to perform a background check and obtain financial information concerning Applicant at any time from any source. Applicant has read the above conditions and hereby agree to them. All orders placed under this account are the responsibility of the named principal even if there is a sale or transfer to new ownership of the named company. If there is a sale or transfer to new ownership of the named company, Elegant Windows, Inc. will set up a new account for the new owner after due notification from all parties and subsequent application for account and credit from the new owner. I, the undersigned, hereby authorize the above named bank to release financial information to Elegant Windows, Inc. I furthermore authorize Elegant Windows, Inc. to obtain credit and financial information from any source at any time which may include a report from a credit report agency. I agree to pay in full for all products ordered or services rendered to, or at the request of, the undersigned in accordance with the terms of each invoice. In addition to personally guaranteeing full payment, I agree to pay Elegant Windows, Inc. for all orders and resulting costs and expenses of cancellation or changes of an order. In the event the account is turned to a collection agency or attorney, I agree to pay all collection costs, court costs, and attorney fees in addition to all other sums due. All disputes, claims or actions or proceedings arising directly or indirectly, shall be litigated at the election of Elegant Windows, Inc. only in courts whose sites are within the County of Tarrant, Texas, and the undersign hereby submits to the jurisdiction of any state or federal court located within the County of Tarrant. The undersigned waived any right which he/she/they may have to transfer or change the venue of any litigation brought against the undersigned by Elegant Windows, Inc. Payment terms are Pre-Payment by Credit Card until further notice.

I warrant that the above conditions have been carefully read and hereby agree to them.