LP Account Application

GEC Energy

LP Account Application

COMPANY NAME (INDIVIDUALS DO NOT HAVE TO COMPLETE THIS SECTION)

ADDRESS

CITY

STATE

ZIP CODE

COMPANY TELEPHONE

EIN OR TIN NUMBER

COMPANY NET WORTH

PRIMARY APPLICANT FULL LEGAL NAME (FIRST, MIDDLE, LAST)

PRIMARY APPLICANT TITLE (IF APPLICABLE)

PRIMARY APPLICANT ADDRESS

PRIMARY APPLICANT CITY

PRIMARY APPLICANT STATE

PRIMARY APPLICANT ZIP CODE

PRIMARY APPLICANT HOME PHONE

PRIMARY APPLICANT MOBILE PHONE

PRIMARY APPLICANT EMAIL ADDRESS

PRIMARY APPLICANT SOCIAL SECURITY NUMBER

PRIMARY APPLICANT DATE OF BIRTH

PRIMARY APPLICANT MARITAL STATUS

CO-APPLICANT FULL LEGAL NAME (FIRST, MIDDLE, LAST)

CO-APPLICANT TITLE (IF APPLICABLE)

CO-APPLICANT ADDRESS

CO-APPLICANT CITY

CO-APPLICANT STATE

CO-APPLICANT ZIP CODE

CO-APPLICANT HOME PHONE

CO-APPLICANT MOBILE PHONE

CO-APPLICANT EMAIL ADDRESS

CO-APPLICANT SOCIAL SECURITY NUMBER

CO-APPLICANT DATE OF BIRTH

CO-APPLICANT MARITAL STATUS

PRIMARY BANK (INCLUDING BRANCH)

PRIMARY BANK PHONE NUMBER

TYPE OF ACCOUNT REQUESTED

ANNUAL INCOME

THE UNDERSIGNED APPLICANT AND CO-APPLICANT AGREE THAT THE FOLLOWING TERMS WILL GOVERN ANY PURCHASES MADE WHICH ARE CHARGED TO ANY OPEN CHARGE ACCOUNT THAT APPLICANT AND/OR CO-APPLICANT MAY HAVE WITH GOLD EAGLE COOPERATIVE (GEC)

1. BALANCE DUE IN FULL BY THE 15TH OF THE MONTH FOLLOWING MONTH OF PURCHASE.
2. AN UNPAID BALANCE WILL BE ASSESSED A FINANCE CHARGE OF 1.5%, WHICH IS AN APR OF 18% PER YEAR STARTING ON THE 16TH DAY OF THE MONTH (THIS RATE IS SUBJECT TO CHANGE WITH NOTICE ON THE MONTHLY STATEMENT).
3. PAYMENTS SHALL BE FIRST APPLIED TO THE UNPAID FINANCE CHARGE AND THE REMAINDER TO THE UNPAID BALANCE.
4. IN THE EVENT COLLECTION ACTION BECOMES NECESSARY TO COLLECT ON THE ACCOUNT, ANY AND ALL COSTS INCURRED BY, INCLUDING COLLECTION SERVICE PAYMENTS, COURT COSTS, AND ATTORNEY FEES WILL BE APPLIED TO THE OUTSTANDING ACCOUNT BALANCE.
5. IF APPLYING FOR A JOINT ACCOUNT, BOTH APPLICANT AND CO-APPLICANT AGREE TO BE BOUND BY THE TERMS OF THIS AGREEMENT, AND EACH AGREES TO BE JOINTLY AND SEVERALLY LIABLE FOR PAYMENT OF ALL PURCHASES MADE UNDER THIS AGREEMENT.
6. GEC SHALL HAVE THE RIGHT TO LIMIT OR TERMINATE THIS CHARGE ACCOUNT, BUT THE LIMITATION OR TERMINATION SHALL NOT AFFECT THE OBLIGATION TO PAY AN EXISTING ACCOUNT BALANCE. UPON TERMINATION, GEC MAY AT ITS OPTION DECLARE THE ENTIRE BALANCE DUE AND PAYABLE IMMEDIATELY.

THIS DOCUMENT AUTHORIZES THE RELEASE OF ANY AND ALL OF APPLICANTS’ AND/OR CO-APPLICANT’S FINANCIAL INFORMATION TO GEC BOARD MEMBERS, MANAGEMENT, LEGAL ADVISORS, AND ACCOUNTANTS, AND RELEASES GEC AS THE CUSTODIAN OF SUCH RECORDS, BOTH INDIVIDUALLY AND COLLECTIVELY, FROM ANY AND ALL LIABILITY FOR DAMAGES WHICH MAY RESULT DUE TO RELEASE OF THIS INFORMATION PURSUANT TO THIS AUTHORIZATION. THE UNDERSIGNED FURTHER AUTHORIZES GEC TO OBTAIN BUSINESS CREDIT REPORTS FROM CREDIT BUREAUS OR OTHER CREDIT PARTNERS AND SHARE ANY AND ALL INFORMATION IN THEIR CARE, CUSTODY, AND CONTROL CONCERNING THE UNDERSIGNED APPLICANT AND/OR CO-APPLICANT AS WELL AS ANY INFORMATION RECEIVED PURSUANT TO THIS AUTHORIZATION. THE UNDERSIGNED APPLICANT AND CO-APPLICANT HEREBY RELEASES GEC AND FROM ANY AND ALL LIABILITY FOR DAMAGES OF WHICH MAY RESULT DUE TO THE RELEASE OF THIS INFORMATION PURSUANT TO THIS AUTHORIZATION. IT IS EXPRESSLY AGREED THAT A PHOTOCOPY OF THIS AUTHORIZATION SHALL BE AS VALID AS AN ORIGINAL.

PRIMARY APPLICANT PRINTED NAME

DATE

CO-APPLICANT PRINTED NAME

DATE

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GEC Energy

LP Account Application

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