Please enable JavaScript in your browser to complete this form. - Step 1 of 2Company Representative *FirstLastName of person filling in the formYour K&N Sales Rep *Company DetailsEstimated Monthly Volume With Us *Taxable Status *TaxableNon-TaxableLimited Sales Tax Permit # *Name of Firm *Business Classification *LLCCorporation (S or C)Sole ProprietorshipIndependent / OtherYears in Business *Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhone *Email for Invoicing and Monthly Statements *FaxBusiness OwnershipOwner or Financially Liable Individual *FirstLastOwner or Financially Liable Individual's Home Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhone *Social Security # *Secondary Owner or Financially Liable IndividualFirstLastSecondary Owner or Financially Liable Individual's Home AddressAddress Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePerson to Contact about Accounts Payable *FirstLastEmail *Phone *PROCEED TO REFERENCESBank ReferencesName of Bank *City *Account # *Person to Contact *FirstLastTheir Email Address *Their Phone Number *Trade ReferencesReference Company 1 *Contact Person *FirstLastTheir Email Address *Their Phone Number *Reference Company 2 *Contact Person *FirstLastTheir Email Address *Their Phone Number *Reference Company 3 *Contact Person *FirstLastTheir Email Address *Their Phone Number *I accept the following terms and conditionsI (We) understand that the information furnished to you in this form is for the purpose of obtaining credit from your firm. That I am (we are) authorized to bind my (our) firm accordingly. That all accounts or monies due to you shall be due and payable at your place of business in Houston, Harris County, Texas. That all past due accounts, notes or judgements shall automatically draw interest at the rate of ten percent (10%) per annum. Accounts not paid by 10th day of the month next following date of shipment will be deemed past due. Venue on any suit to collect a past due account shall be in Harris County, Texas. Nothing in this agreement shall be construed as requiring or allowing the charging of an interest rate greater than that allowed by law in the State of Texas. I (We) understand that the information furnished you on this page is for the purpose of obtaining credit from your firm, and that I am (we are) authorized, in my (our) capacity, to jointly and severally, unconditionally guarantee and promise to be held personally liable for all indebtedness accrued under this continuing agreement. That all past due accounts, notes or judgements shall automatically draw interest at the rate of ten percent (10%) annum. In event of repossession of merchandise, the undersigned agrees to pay 25% restocking charge. In the event of default and referral to an attorney or collection agency, I (We) agree to pay rescuable cost and attorney's fees of at least twenty percent (20%). CREDIT TERMS : NET 10TH EOM EmailSubmit