Commercial Credit Application & Agreement Hensall Co-op

Commercial or Farm-Use

Account Application & Agreement

Please complete the form online and submit. You will receive a confirmation email if you provide an address.

Fields marked with * are required.

For your convenience, a fillable pdf form is provided here should you wish to mail, email or fax your application to us.

In order to have charge privileges, either a consumer credit application or commercial credit application must be completed and approved as per our credit policy. Our payment options provide several options to keep your account in good standing.

Terms & Conditions

BUSINESS INFORMATION
* Legal Business Name
Trade Style (if different from above)
* Type of Business	Corporation Partnership Sole Proprietorshp
Business Registration Number
CONTACT INFORMATION
* Full Mailing Address
Service Address If services are to be provided if different from the mailing address.
* Primary Phone Number
Fax Number
* E-mail
BUSINESS PRINCIPALS OR PARTNERS
Principal or Partner 1 (P1)
P1 Last Name
P1 First Name
P1 Date of Birth mm/dd/yyyy
P1 Do you have any off-farm income?	No Yes
P1 If yes, please provide details:
Prinicpal or Partner 2 (P2)
P2 Last Name
P2 First Name
P2 Date of Birth mm/dd/yyy
P2 Do you have any off-farm income?	No Yes
P2 If yes, please provide details
BANKING INFORMATION
* Bank
* Full Address
Account Number
Account Manager
Branch's Phone Number
How long at this branch?
ADDITIONAL INFORMATION
* Products/Services Needed Please check all that apply.	Feed Crop Inputs Propane Petroleum Other
Years in Business
Acres Rented
Business Type
Acres Owned
Crops Grown:
Type of Livestock
Number of Head:
* Go Green Initiative Help us go green - receive your statements by email!	Email No thank you.
* Applicant(s) Authorization By entering your name(s) and clicking "Apply for Credit", you: 1) have read, understand and agree to the terms and conditions stated, 2) are signing this application electronically, 3) agree your electronic signature is the legal equivalent of your manual signature, and 4) agree to the terms and conditions stated.
* Date mm/dd/yyyy
GUARANTEE In consideration of Hensall Co-op extending credit to the Corporation (the "Corporation') described in "Terms and Conditions", the sum of TWO ($2.00) DOLLARS now paid by Hensall Co-op to the undersigned (the receipt and sufficiency whereof is hereby acknowledged) and other good and valuable consideration, the undersigned guarantor(s) hereby irrevocably and unconditionally guarantee(s) the payment of all present and future indebtedness of the Corporation to Hensall Co-op. This guarantee is a continuing guarantee. The obligation and liability on the part of the undersigned shall be primary, payable immediately upon demand and without recourse first having been mady by Hensall Co-op against the Corporation. The undersigned shall be responsible for and shall reimburse Hensall Co-op for all costs and expenses incurred by Hensall Co-op in connection with the enforcement of this guarantee, including solicitor costs on a substancial indemnity basis.
* Date
Guarantor Entering your name here and submitting this form will be considered your signature and acceptance of all terms and conditions stated above and related to this application.
Guarantor 2 Entering your name here and submitting this form will be considered your signature and acceptance of all terms and conditions stated above and related to this application.