If yes, attach the current exemption certification.
Please fill out the Bank Information
& Trade References below
I hereby authorize KSI Trading Corporation Inc. to verify my reference and to contact Credit Reporting Agency/Bank for purposes of obtaining credit. I do hereby certify that the information provided herein is true and accurate and it is understood that the creditor will rely thereon. It is agreed that in the event that this or any account of the applicant is not paid according to its terms, the applicant will be additionally liable for all collection agency fees and all costs incurred but not limited to, attorney fees, interest of the highest amount permitted by law and costs and disbursements if collection procedures are required.
I hereby authorize KSI Trading Corporation Inc. to verify my reference and to contact Credit Reporting Agency/Bank for purposes of obtaining credit. I do hereby certify that the information provided herein is true and accurate and it is understood that the creditor will rely thereon. It is agreed that in the event that this or any account of the applicant is not paid according to its terms, the applicant will be additionally liable for all collection agency fees and all costs incurred but not limited to, attorney fees, interest of the highest amount permitted by law and costs and disbursements if collection procedures are required.
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