Credit:  Dated: 

   Name: 

Address: 

   City:  St:  Zip: 

Office Telephone:  Home Telephone: 

 Social:         DOB: 

D/F & Sales Tax Info:  

  Spec. Fuel Tax No.:  

        Resale Tax #: 

Employer:  Employers Phone: 

How Long: 

  Spouse:  Spouse Employer: 

Spouse Social: 

Relative: 

Years Established: Type of Business: 

Corporation Officers: 

Bank:  Branch: 

Bank Contact: 

Have you ever filed bankruptcy? Yes No  If yes, when? 

How long at present address:  Do you Own Rent your home?

Business Credit Reference:

Name:                     Acct. #       Exp. Date Phone

Monthly Gallon Estimate:  # of Vehicles:  # of Cards Request: 

In consideration of Wondrack, hereinafter called Seller, granting credit, the undersigned hereby

guarantees the payment when due of all Seller's charges for the account of above customer of

whatever nature. Unless otherwise provided by agreement between the parties, I agree to pay a

service charge of 1 1/2% (18% annually) on delinquent balances.

I hereby waive diligence, demand and notice from you or your part, and authorize Seller to change the time for payment by me without notice. This guarantee is a continuing one and shall remain in force until such time as you receive at your office written notice to the termination thereof from the undersigned. In the event that Seller is forced to retain an attorney to collect the amount due them, I, the customer, agree to pay (in addition to all sums due Seller for the price of said merchandise and service charges) all expenses incurred by Seller. In the event that Seller commences any legal

proceeding or action to enforce such collection, I further agree that I will pay all necessary and

proper costs and charges paid or incurred by Seller in connection with said legal proceedings or

actions, and in addition thereto, such additional sums as the Court may adjudge reasonable as

attorney fees in such proceedings or actions.

I agree that the venue of any such litigation arising between these patties shall be placed respectively in either Benton, Franklin, Yakima Counties, Washington or in Umatilla County, Oregon at Seller's option. Everything that I have stated in this application is correct to the best of my knowledge. I understand that you will retain this application whether or not it is approved. You are authorized to check my bank account, credit and employment history and to answer questions about your credit experience with me.