Credit Application

Apply for Credit Terms with DATAQ




The signing of this application authorizes DataQDirect (Secured Party) to perform the Necessary credit investigation on the above company. I authorize the above references to release information Necessary for DataQDirect or a DataQDirect Agent to make an informed credit decision. DataQDirect is authorized to make all inquiries deemed Necessary to deterministic mine our credit worthiness. Assigned DataQDirect or agent is authorized to answer questions about Their credit experience with us, and share this information with other institutions to secure financing.


To secure payment for all purchases from Secured Party, now and in the future, Client / Debtor hereby grants Secured Party a continuing security interest in all client / Debtor's presently owned or hereafter (a) goods, (b) instruments, (c) Chattel paper, (d) documents, (e) accounts, (f) accounts receivable, (g) general intangibles, and (h) payment intangibles and together with all Proceeds thereof and all support obligations. The Following Constitute client defaults: Non-payment in timely fashion of Client's indebtedness to DataQDirect, bankruptcy, insolvency, or assignment for the benefit of creditors; misrepresentation in respect of any provision of this Agreement or any in between DataQDirect and client. In the event of default DataQDirect May declare all unpaid balances due. Client authorizes Secured Party to file a UCC Financing Statement (or if Canadian PPSA client) Describing the collateral for the purpose of protecting Secured Party's interest. HOWEVER, at DataQDirect's discretion, UCC (or if Canadian PPSA client) May or May Not be filed.


The information contained in is submitted by the client for the purpose of Obtaining credit. Client Expressly Agrees to make payment in full within the approved terms to DataQDirect for the purchases in accor dance with invoice (s). Should the client default in any payment investigation, all Amounts owed by Client DataQDirect Shall become due and payable immediately Extended. Further Client Agrees to pay a reasonable attorney's fee and all other costs and expenses incurred by the client in the collection of any obligation of Client Pursuant hereto. This agreement Shall become effective When accepted by client.


Please note did the approval process May take up to 72 hours


Company Name (REQUIRED)
Email Address
First Name
Last Name
Street Address
Zip Code
Date Business Commenced
Type of Business
Bank Name
Social Security / TAX ID
Bank Street Address
City Bank
State Bank
Bank Zip Code
Account Type
Account Type 2
Account Number
Dun and Bradstreet
Credit Card Number
Name on Card
Billing Address
Expiration Date
Security Code