Name / Address

Company Information

Sole Proprietor Partnership Corporation

Officer Information

Bank References

Trade References (please provide only active accounts)

Credit Certificate

In order to permit Quality Network Components (QNC) to consider credit terms of sale for purchases made by the undersigned or its agents, herewith applied for, the undersigned acknowledges that each month, or portion thereof that the same remains unpaid, commencing from and after the date of thereof, should QNC incur any attorney fees with or without the institution of court or arbitration proceeding in connection with the collection of any account due to the undersigned, the undersigned agrees to pay reasonable attorney fees and all court and arbitration cost in connection with any such proceedings. Buyer also agrees to pay $20 for each check issued by buyer to QNC which is returned without payment. In signing this document buyer grants permission for credit information to me obtained by QNC from companies the Buyer has specified. The signature below acts as the releasing authority to the companies approached for credit information by QNC. The undersigned understands that QNC will keep this application whether or not this application is approved and that QNC will consider this application as a continuingstatement of undersigned financial condition until notified otherwise. The information and statements in this application are true and complete, and are made for the purpose of inducing you to establish a line of credit.