Greenbelt News Review - Credit Application

Greenbelt News Review
15 Crescent Road, Suite 100, Greenbelt, MD 20770
Phone: 301-474-4131 Fax: 301-474-5880
E-mail: newsreview@greenbelt.com

CREDIT APPLICATION

APPLICANT:

Organization Name and Address:

Contact Name and Phone:

REFERENCES:

Bank Account Name and Address:

Phone and Account Number:

Credit Account Name and Address:

Phone and Account Number:

AGREEMENT:

Statements will be rendered monthly. Payment is due 28 days after the statement date. If payment is not received within that time, a 1.5% monthly late fee will be charged. Once an account is 45 days past due no additional ads will be accepted. If an account has been closed for non-payment, all past due amounts and interest must be paid before any future ads will be accepted. In addition, all ads must be prepaid for 3 months. All accounts will be considered correct if we are not notified in writing within 20 days of receipt of the statement.
I have read and agree to abide by the above.

Signature: _________________________________ Date:

Printed Name:
Title:

HOW TO SUBMIT THIS FORM
Fill out the form on this webpage, print it, sign it, then submit it to the
News Review office via mail, fax or hand delivery. No e-mail, please.

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APPLICANT:
Organization Name and Address:			Contact Name and Phone:
REFERENCES:
Bank Account Name and Address:			Phone and Account Number:
Credit Account Name and Address:			Phone and Account Number:

AGREEMENT:
Statements will be rendered monthly. Payment is due 28 days after the statement date. If payment is not received within that time, a 1.5% monthly late fee will be charged. Once an account is 45 days past due no additional ads will be accepted. If an account has been closed for non-payment, all past due amounts and interest must be paid before any future ads will be accepted. In addition, all ads must be prepaid for 3 months. All accounts will be considered correct if we are not notified in writing within 20 days of receipt of the statement. I have read and agree to abide by the above.
Signature: _________________________________			Date:
Printed Name:			Title: