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  • Office Hours: 8am - 4:30pm
    Scale Hours: 7am - 3:30pm

Credit Application

Thank you for your interest in doing business with Linwood Mining & Minerals. To establish a credit account with us, please complete the application form below. The information you provide will help us process your request quickly and accurately.

If you have any questions or need assistance while completing the form, feel free to contact our accounting department at 563-344-3748 or email us. If you would prefer to fill out a paper application click here to download and mail to 5401 Victoria Ave., Davenport, IA Attn: Linwood Accounting Dept.

We look forward to working with you.

NOTE: IF YOU NEED TO MAKE A REVISION TO YOUR EXISTING APPLICATION, CONTACT US DIRECTLY, 563-344-3748 or email us.

Application for Credit

Application for Credit

Business Type

Select your business type to ensure we collect the appropriate information for your application.

Business Information

Provide details about your company to help us evaluate your credit application.

Business Address
Business Address
City
State/Province
Zip/Postal
Leave blank if not applicable.
Parent Company Address
Parent Company Address
City
State/Province
Zip/Postal

Bank Information

Individual Applicant Information

If you are applying as an individual, please complete the information below.

Address
Address
City
State/Province
Zip/Postal
Enter your Social Security Number in the format: 123-45-6789

Financial History

Please let us know if you have ever filed for bankruptcy. If yes, you’ll be asked to provide a brief explanation.

Have you ever filed backruptcy?

Ownership / Officers

List all company officers, partners, or proprietors.

Credit References Business

Please provide up to five business credit references.

Credit References Individual

Please provide up to five business credit references. If you are applying as an individual, this section is optional.

Job or Project Details

If this credit application is related to a specific job, please provide the following information.

Tax Exempt

Maximum file size: 157.29MB

We must be notified of any tax exemption prior to shipments of material. Sales tax will be charged if a valid exemptions certificate is not received.
Contractor Address
Contractor Address
City
State/Province
Zip/Postal
Country
Billing Frequency

TERMS AND CONDITIONS

Applicant’s signature attests financial responsibility, ability, and willingness to pay according to our credit terms as stated on the invoices and in this application for credit. Linwood Mining and Minerals Corp. (herein referred to as Linwood) reserves the right to CHARGE INTEREST for amounts not paid according to these terms at the rate as stated on the invoices (or at 18% annual if no rate is stated on the invoice) on the unpaid balance. Linwood also reserves the right to LIMIT OR TERMINATE CREDIT if account is not paid according to these terms and conditions or as Linwood deems necessary. Applicant also agrees to pay Linwood a fee when their payment is returned to us for non-sufficient funds.

 

 

This applicant and the information contained herein is a request for the extension of credit for commercial business use only. The applicant authorizes Linwood to obtain a written or oral credit report from any credit reference or any credit reporting agency. Applicant further authorizes any bank or commercial business with whom the applicant is doing or has done any type of business to give any and all necessary information to Linwood which will assist Linwood in it’s credit investigation. The applicant further authorizes Linwood to investigate the applicant’s credit status from time to time as Linwood deems necessary. Any changes in legal status must be communicated to Linwood by certified mail within 30 days. The original applicant will remain liable until such time as Linwood has received notice of change in legal status, been given a reasonable period of time to respond to such notice, and to establish credit for the new entity. Further, should this account be placed for collection, the applicant agrees to pay all costs of collection of the outstanding debt including, but not limited to, attorney’s fees, court costs, collection fees, and interest until the debt is paid in full.

By submitting this form, you consent to Linwood Mining & Minerals collecting and securely storing your personal information for the purpose of evaluating credit. Your information will not be shared or used for any other purpose.

Signature

An authorized individual must sign this application to validate and submit it for review.

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