131 Village Square/  Batesville, IN 47006/  812-934-5611/  Fax: 812-934-5689
Please print this form to complete and fax to (fax) 812-934-5689
Business Name ____________________________________________________________________
Mailing Address____________________________________________________________________
Shipping Address___________________________________________________________________
E-mail Address_____________________________________________________________________
Telephone__________________________ Fax Number____________________________________
The business began______________ Sole Proprietorship___Partnership ____Corporation_____
                                                            
                                                             Subsidiary of____________________________________
The owners or, if corporation, the officers are:
Title                          Name                              Home Address                 Home Telephone
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
                                                           Present Suppliers
Name                                                          Address                                                  Telephone
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
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Bank Name and Address_____________________________________________________________
Account#______________________Phone______________Contact__________________________
Parties hereby agree that all purchases made are subject to the following terms and conditions:
1. The undersigned purchaser hereby agrees that all amounts due for goods and services purchased from
The Office Shop, Inc. are payable at 131 Village Square, Batesville, IN 47006.
2. The undersigned purchaser hereby agrees that all amounts due The Office Shop, Inc. are payable 30 days
following the date of invoice.  If any amounts due The Office Shop, Inc. are not paid within said period, the
undersigned purchaser agrees to pay a service charge of 2% per month of the outstanding balance which shall
be added to the sum due.
3. The undersigned purchaser agrees to pay, in the event his account becomes delinquent and is turned over
to an attorney for collection, attorney’s fees in an amount equal to one-third of the total unpaid account
(including unpaid principal and late charges) plus all court cost and attendant collection cost.
4.The parties hereby acknowledge that the goods and/or services purchased from The Office Shop, Inc.
are not payable in installments, but are payable in full as stated herein.
5. This agreement is to be construed and interpreted under the laws of the State of Indiana.
Printed Name____________________________________________________________________
Signature_____________________________________________________Date___/_____/______
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===============FOR CORPORATIONS – PLEASE COMPLETE THE FOLLOWING==================
                                               PERSONAL INDEMNITY AND GUARANTEE
To induce The Office Shop, Inc. to approve this Credit Application and Purchase Agreement and in consideration
of its so doing, we, the undersigned, do hereby jointly, severally and personally guarantee the above corporate
purchaser’s full performance of said purchase agreement and hereby agree to reason of, or related to, the
above corporate purchaser’s failure to perform or to pay when due, charges incurred in accordance with the
agreement. The above purchase agreement may be modified by The Office Shop, Inc. and the Corporate
Purchaser executing same without notice to the undersigned and without affecting this indemnity and
guarantee. The Office Shop, Inc. may enforce this agreement against the undersigned or any of them,
jointly or severally, whether or not any action is ever taken by it against the above Corporate Purchaser. 
Print Name_____________________________________________SS#_________________________
Signature_______________________________________________Date_________________________
Print Name_____________________________________________SS#________________________
Signature_______________________________________________Date________________________

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