HEMET VALLEY RV
NEW CUSTOMER DATA SHEET AND CREDIT APPLICATION
                                                                                             Date___________________________
                                                                                             Date started or
Business Name_______________________________ purchased business_______________

Billing
Address___________________________________________________________________

Phone (     )_____________________________ Fax (      )_____________________________

Principal business, service, product_______________________________________________

Delivery Address_____________________________ City__________________ Zip________


Phone (      )______________ Receiving Hours ______________ Sales Tax No____________
                                                                                                                                   (Attach copy of certificate)
Business Operated as: (circle one)             Corporation               Proprietorship                 Partnership

We are a branch/division/subsidiary of_____________________________________________

City __________________ State ____ Zip_________ Bills paid from:   Local Office  Main Office

Key Personnel:
Owner/Manager/President___________________ Treasurer/Controller___________________

Purchasing Agent________________________  Accounts Payable______________________

                                                             CREDIT INFORMATION

Bank____________________________________

Acct #____________________________________

Branch______________ Phone (      )___________

Address_________________________________

City_________________________ Zip_________

TRADE REFERENCES: Please list 3 w/complete addresses

1. Name_________________________________

Address_________________________________

City_________________________ Zip_________

Phone (      )______________________________

2. Name_________________________________

Address_________________________________

City_________________________ Zip_________

Phone (      )_______________________________

3. Name_________________________________

Address_________________________________

City_________________________ Zip_________

Phone (      )_______________________________


Signature of
Customer______________________________________Title________________________


HVRV OFFICE USE:

Bank____________________________
________________________________
________________________________
Trade____________________________
________________________________
________________________________
D&B Rating_________
__________________
Proposed Credit Limit
__________________
Credit Initials________
__________________
________________________________
Management Approval_______________
Comments________________________
________________________________
________________________________
Computer Input:
By_________________________
                    
Date________________________
Initial Credit Limit
CONDITIONS OF SALE: The undersigned
expressly agrees to make payment in full for
all purchases in accordance with the invoice
terms. Should the undersigned default in any
such payment, the undersigned expressly
agrees to pay a late service charge on any
amounts in default at the maximum rate
permitted by law, and, all amounts owed by
the undersigned shall become immediately
due and payable.  The undersigned further
agrees to pay a reasonable attorney's fee
and all other costs and expenses incurred in
the collection of any obligation of the
undersigned pursuant hereto.