DOWNEAST BICYCLE SPECIALISTS - NEW ACCOUNT AND CREDIT APPLICATION

Please include copy of your “yellow pages” ad with this application

Business Information

Legal Business Name_______________________________ DBA (if applicable)_______________________________

Billing Address____________________________________ Shipping Address__________________________________

City/State/Zip_____________________________________ City/State/Zip____________________________________

Phone__________________________ Fax____________________________ E-Mail__________________________

Sole Proprietorship____ Partnership____ LLC____ Corporation____ Federal Tax ID No.___________________

State Resale Number__________________ Date Established____________ Present Ownership Since____________

Manager_____________________ Buyer______________________ Payables Contact_______________________

Insurance Co._________________________ Policy Number________________ Dollar Limit____________

Insurance Co. Contact_____________________ Phone_________________

Principals

Name__________________________________________ Name___________________________________________

Address________________________________________ Address__________________________________________

City/State/Zip___________________________________ City/State/Zip_____________________________________

Social Security #_______________ Phone____________ Social Security #________________ Phone_____________

Bank Information

Name of Bank/Branch_____________________________ Bank Officer_____________________________________

Address_________________________________________ Phone______________________

City/State/Zip___________________________________ Checking Account Number_____________________

Bike Lines Carried

1. _____________________ 2. _____________________ 3. ____________________ 4. ____________________

Terms Requested

CREDIT CARD_____ COD____ Open Account____ Amount of Credit Requested______________

Trade Credit References & Acct #’s (√ all that apply...3 minimum)

 Action Bicycle USA______  Hawley Co.______ › Sinclair Imports, Inc. ______

› J &B Importers______ › Shimano America______ › C-Tel ______

› K2 Bike______ › Thule______ › Fuji America______

› Quality Bicycle Products______ › Yakima______ ÿ Veltec Sports______

› Gita Sporting Goods, Inc. ______ › Security Bicycle Accessories______

› Other _____________________________________________________________________

Personal Guarantee of Credit

In consideration of Downeast Bicycle Specialists extending credit to the Credit Applicant, I/we hereby guarantee the prompt payment when due of every claim Downeast Bicycle Specialists may have against the Credit Applicant. This is a continuing guarantee and shall remain in force until revoked by me/us in writing. Such revocation shall be effective only as to claims which arise subsequent to such notice. This guarantee is unconditional. It’s purpose is to pledge the personal credit and assets of the signer(s) for all credit extended to the Credit Applicant by Downeast Bicycle Specialists. Should the Credit Applicant default, the undersigned expressly agrees to pay the late payment service charges on any amounts in default up to the maximum permitted by law, and, at Downeast Bicycle Specialists’ option, all amounts owed to Downeast Bicycle Specialists by the undersigned shall become immediately due and payable. The undersigned further agrees to pay any reasonable attorney’s fees and all other costs and expenses incurred by Downeast Bicycle Specialists in the collection of the just obligation. It is also agreed that Oxford Maine will hold venue for all court actions.

Executed by the undersigned as individual(s) and not as corporate officers:

Signature_____________________________ Print Name________________________ Date______________

Signature_____________________________ Print Name________________________ Date______________

Fax to: 1-800-704-0879. Mail the original to: Downeast Bicycle Specialists; PO Box 226; Fryeburg, ME 04037 11/11/02