K&M TIRE Credit Application

Apply for Credit - K&M Tire

Sign up today for an account with K&M Tire.
By completing and submitting the form below, you are requesting an account with K&M Tire. Approval, credit limits, and payment terms are determined at the sole discretion of K&M Tire based on credit evaluation and other relevant factors.
Submission of this application does not constitute approval or a guarantee of credit.

Business Name & Type
Business Name & DBA
Business Type
Business Address & Information
Shipping Information
Billing Information Copy Shipping Address
Contact Information & Account Details
Is a Purchase Order Required?
Email address for weblink. This will be your user name account (K&M's online website). Leave blank to opt out of online access.
Email address for statements. (Statements are automatically emailed, leave blank if you want to opt out and have your statement mailed.)

****IF PROPRIETORSHIP, AFTER REVIEW K&M TIRE WILL REQUEST A COPY OF YOUR DRIVER’S LICENSE, PASSPORT OR GOVERNMENT ISSUED ID****

List All Officer / Owners
Owner 1
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Have any Offices / Owners previously done business with K&M Tire?
Blanket Certification of Exemption
Are you Sales Tax Exempt?

This certificate shall continue in force until revoked and shall be considered a part of each order given to the above-named vendor unless the order specifies otherwise.

The undersigned hereby claims exemption to purchases of tangible personal property from K&M Tire on and after the date below and certifies that this claim is based upon that the purchaser’s proposed use of the item purchased shown hereon:

**Accounts without a valid Sales Tax Exemption # will be required to pay all state sales tax** 

Account Application
What type of account are you applying for?
*** C.O.D. DISCLOSURE AGREEMENT ***

In the event that we receive a returned check, you will be liable for the original amount of the check plus the sum of $25.00, and/or for all cost and expenses, including attorney fees, that are accrued upon collection proceedings of the unpaid balance, whichever is greater including 2% interest earned per month on any unpaid balance. Credit card payments processed are subject to 3% of stated payment amount subject to state law. By signing this document, I the undersigned verify that all information contained herein is true and accurate to the best of my knowledge. Any falsification or omitted information gives the seller grounds to terminate business relations.

*** CHARGE ACCOUNT INFORMATION AND AGREEMENT ***
CHARGE ACCOUNTS ARE PENDING CREDIT DEPT APPROVAL
Trade References (Current & Past)
Reference 1
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The following ACCOUNT INFORMATION is required to properly evaluate your financial statements.

If credit limit request is over $25,000, copies of your two (2) most recent fiscal year-end financial statements, including balance sheet and profit and loss statement, are required to process this Credit Application and will be required annually if an account is established. Please send financial statements, mark “Confidential,” and mail to: K&M Tire Attn: Credit Department, P.O. Box 279 Delphos, Ohio 45833.

Terms and Conditions (must be signed in order to get an account)

In the event credit is extended, the applicant agrees as follows:

1. Applicant agrees to make payments of all invoices per terms of Net 10th prox. unless otherwise stated on the face of the invoice to seller's address and on any balances outstanding from time to time; in the event of a default of timely payment by the applicant to pay the outstanding principal balance plus accrued interest and expenses on demand as follows:
a. To pay interest on any unpaid balance not paid within the time provided by the invoice at the rate of 2% monthly or max. rate permitted by law.
b. In the event of default in the acceptance of goods or services ordered or in the payment for goods or services received, to pay all costs, expenses, including reasonable attorney's fees, incurred in remedying the default or the enforcement of any rights possessed by seller.
c. Any check returned to seller as non-sufficient funds will be charged an additional fee at the highest lawful rate.

2. Shipments may be held if my account is delinquent or exceeds my established line of credit.
3. Applicant agrees to provide seller with sixty (60) days’ notice of its intention to sell all of its assets.
4. Applicant agrees to pay 3% of stated payment amount for Visa, MasterCard, American Express and/or Discover credit or debit card purchases.
(Credit card fees charged subject to state law)

To secure payment and performance of all obligations Debtor hereby grants to Secured Party a continuing purchase money security interest in all inventory, equipment, and goods manufactured by or distributed by Secured Party, wherever located, now owned and hereafter acquired including but not limited to all Products distributed and sold by K&M Tire Inc.; and all proceeds from the sales thereof; and all existing or subsequently arising, accounts and accounts receivable and supporting obligations which may from time to time hereafter come into existence during the term of this Security Agreement. Secured Party's purchase money security interest is explicitly limited to outstanding obligations between K&M Tire and Debtor.

By signing this document, I the undersigned verify that all information contained herein is true and accurate to the best of my knowledge
Any falsification or omitted information gives the credit grantor grounds to terminate any and all charge privileges.
By signing this document, I the undersigned verify that all information contained herein is true and accurate to the best of my knowledge.
By signing this document, I the undersigned understand that the Long Arm of the Law is applicable, and conflicts will be resolved in the state of Ohio.

**Photocopies will hold applicant liable for the same Terms & Conditions as stated in the Original Documentation**
All Owners, Partners, or Officers of the Corporation must sign below:
Signature 1
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Personal Guarantee (optional, but recommended)

In the event credit isn't extended, the personal guarantor can be signed to potentially approve the application:

In consideration of seller extending credit to applicant (hereinafter referred to as the "company") we the undersigned, absolutely and unconditionally personally guarantee the full and punctual payment of any obligation of the company and we hereby bind ourselves to pay you on demand any sum including all costs of collection and reasonable attorney's fees which may become due to you by the company whenever the company shall fail to pay the same. It is understood that this guarantee shall be a continuing and irrevocable guarantee and indemnity for such indebtedness of the company. We do hereby waive notice of demand, protest or default and consent to any modification or renewal of the credit agreement hereby guaranteed. This guarantee shall be binding on guarantor's heirs, personal representatives, successors, and assigns, and shall insure to the benefit of seller, its successors, and assigns. Each guarantor also hereby waives any claim, right or remedy which such guarantor may now have or hereafter acquire against the [debtor] that arises here under and/or from the performance by any guarantor hereunder including, without limitation any claim, or right of subrogation, reimbursement, exoneration, contribution, indemnification, or participation in claim, right of remedy of [creditor] against the [debtor] or any security with the [creditor] now has or hereafter acquired, whether or not such claim, right arises in equity, under contract by state, under common law or otherwise.

The undersigned personal guarantor, recognizing that his/her individual credit history may be a necessary factor in the evaluation of this personal guarantee, hereby consents to and authorizes the use of a consumer credit report on the undersigned, by the above-named business credit grantor, from time to time as may be needed, in the credit evaluation
process.

**Photocopies will hold applicant liable for the same Terms & Conditions as stated in the Original Documentation**
All Owners, Partners, or Officers of the Corporation must sign below:
Signature 1
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ECOA NOTICE: The federal Equal Credit Opportunity Act prohibits creditors from discriminating against Credit Applicants on the basis of race, color, religion national origin, sex, marital status, age (provided the Credit Applicants has the capacity to enter into a binding contract); because all or part of the Credit Applicant's income derives from any public assistance program; or because the Applicant has in good faith exercised any right under the Consumer Credit Protection Act. The federal agency that administers compliance with this law concerning this credit is the Federal Trade Commission, Division of Credit Practices, 6th and Pennsylvania Avenue NW, Washington, D.C. 20580

By clicking the “Submit” button, you agree to the terms outlined in the disclosure(s) selected. The parties agree to conduct the transaction(s) contemplated by this Credit Application using electronic signatures and electronic records. Each Party consents to the use of and agrees to be bound by electronic signatures, electronics records, and electronic delivery of notices and documents. The parties further agree the use of electronic signatures and electronic records herein is intended to satisfy any requirement that signatures or records be "in writing" under applicable law, including but not limited to the Electronic Signatures in Global and National Commerce Act (15 U.S.C. § 7001 et seq.) and the New York Electronic Signatures and Records Act (N.Y. State Tech. Law § 301 et seq.)