New Customer SetupPlease enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Dear Customer: Please complete and print the following information to establish your account. After completing this form in its entirety, email it to NewCustomers@mexcor.com. Thank you! COMPANY/DBA/CORPORATION: *LayoutIf part of a chain, please list name:STATE ALCOHOL LICENSE NUMBER: *THC PERMIT NUMBER (if applicable):LayoutEXP. DATE: *If available, attach photos of Alcohol Permit: *TAX ID / RESALE PERMIT #: *BUSINESS PHONE #: *Business Address: *Address Line 1City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeLayoutBUYER NAME: * BUYER CELL #: *DELIVERY DAYS: *None SelectedMondayTuesdayWednesdayThursdayFridaySaturdaySales Rep:BUYER EMAIL: *DELIVERY TIMES: *ADDT’L DELIVERY INSTRUCTIONS:LayoutPREFERED PAYMENT OPTION: *COD (Collect on Delivery)STATE TERMS (Texas Only)NET 15 - IF ALLOWED BY STATEPAYMENT OPTIONS: *DSDLINK.COM (ELECTRONIC) - PREFERREDCHECK - NOT PREFERREDCustomer is Purchasing: *Wine/LiquorWine/LiquorBeerTHC Based ProductsStatementsLayoutACCOUNTS PAYABLE NAME: *PHONE #: *EMAIL: *Addt'l Statements Layout (copy)NAME:PHONE #:EMAIL:Please select one: *Bar/NightclubWine BarCateringC StoreGroceryHotel/MotelLiquor/PackageMilitaryRestaurantWine ShopOn PremiseSupplierDistributor/WholesalerORDER DEPARTMENT: PHONE – Customer Service phone lines are open 8:00 a.m. to 5:00 p.m. Orders received after 3:00 pm will be processed the following business day SAME DAY ORDER PICK-UP: Requires a TABC Cartage License. The minimum order for pick-up is $100.00. Orders placed by 11:00 a.m. may be picked up the same day at 3:00 p.m. DELIVERY: In selected areas, delivery is via Mexcor Fleet. RETURNED PAYMENTS: A $30.00 service charge (or maximum allowed by state law) will be invoiced to your account for any checks returned to your bank. More than one returned payment in a 12-month period will result in your account being changed to COD terms. FREIGHT CLAIMS (3rd Party): If shipping via Common Carrier or UPS, our legal responsibility cease once the freight carrier accepts the shipment from our facility. Please check shipments immediately for any shortages/damages and be sure the driver notes all discrepancies on the freight bill. File all claims with the trucking company that delivered your order. Do not deduct the cost of the item(s) from your invoice. RETURN POLICY: Merchandise is returnable only at time of receiving the delivery. After driver has left establishment, no returns will be accepted and all sales are final. Please do not make adjustments to current invoices. A credit will be issued when the discrepancy is resolved. We hereby request an open account with Mexcor Importers & US Distributors and affirm that the above information is true. UNLIMITED PERSONAL GUARANTEE: IF THE CREDIT CUSTOMER IS A CORPORATION, THEN THOSE SIGNING THIS APPLICATION, WHETHER SIGNING AS AN OFFICER OR NOT, PERSONALLY GUARANTEE PAYMENT FOR ALL ITEMS PURCHASED ON CREDIT BY THE CORPORATION. A 1 ½% (18% per annum) interest charge will be incurred on all past due invoice(s) and in the event of default, customer will be responsible for any and all costs of collection and/or litigation. A copy of this document is to have the same force and effect as the original. I have read the above and understand that I am required by state credit law to remit payment by the due date established by the state mandated terms. If I fail to remit payment by the due date, I understand that the monies due must be remitted in certified funds, as dictated by state credit law. If I fail to remit payment before the state’s list effective date for the delivery period of the outstanding invoice, I understand that Mexcor Inc. is required by credit law to report me to state as delinquent. LayoutNAME: *TITLE: *DATE:Checkboxes *I Agree*Submit