Credit Application
Please print this form, fill out and fax to Diedrich Drill at 219-324-5962
We understand that an invoice is considered past due if not paid within the terms stated on the invoice and that service charges may be assessed on all past due invoices. We do hereby agree to pay the same. The undersigned further agrees to pay all expenses, and attorney fees paid or incurred by Diedrich Drill, Inc. in endeavoring to collect sums due and owing by the company.
We grant permission for any person or reporting agency to furnish Diedrich Drill, Inc. all information which may be periodically requested. I understand that credit terms and limits are at the sole discretion of Diedrich Drill, Inc. and may be changed at any time.
Authorized Officer of Company Date
Trade Reference(4 Req'd)
For Diedrich Drill use only
Diedrich Drill, Inc. 5 Fisher St. LaPorte, IN 46350