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    General Information

     
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    Company Information

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    Trade References

     
        
     
        
     
        

     
        
     
        
     
        

    Bank Information

     
        
     
        

    Licensed Practitioners, Owners, Officers Information

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    Personal Guaranty

    Giving us your personal guaranty will speed the process of approving your application.

    Continuing Guaranty I (we) the undersigned understand that the information furnished you is for the purpose of obtaining credit from your company, that I am (we are) authorized, in my (our) capacity, to bind my (our) company accordingly. I (we) the undersigned, hereinafter referred to as guarantors, do jointly, severally, and unconditionally guarantee and promise to promptly pay when due any and all indebtedness of Buyer to COS, together with any late payment charge that may accrue thereon, regardless of how such indebtedness is incurred, whether such indebtedness is direct or indirect, absolute or contingent, due or to become due, or exists now or arises hereafter. In addition, the Guarantor(s) agree to pay all costs of collection, legal expenses and attorney’s fees paid or incurred by COS in the collection of Buyer’s indebtedness and in enforcing this Continuing Guaranty. The foregoing indebtedness, principal, interest, costs, expenses and fees are hereinafter called the “Indebtedness.” Each undersigned guarantor agrees to be bound by COS’s Terms and Conditions of Continuing Guaranty. Each undersigned personal guarantor, recognizing that his or her individual credit history may be a necessary factor in the evaluation of this Continuing Guaranty, hereby consents for and authorizes COS to obtain and use consumer credit reports for each undersigned, from time to time as may be needed to valuate the credit of Buyer and/or the undersigned.
    PRINT AGREEMENT
     
        
     
        
     
        

    Attachments

    Please attach documents relevant to the application decision process (i.e., company financials, relevant license information, etc)
    Attachment Description Attachment Location
    Note: Accepted file formats include PDF, CSV, TXT and various image files (JPEG, JPG, GIF, BMP, TIFF, TIF, PNG, ICO). File attachments must not exceed 10 MB in combined size.

    Terms and Conditions

     
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    PRINT AGREEMENT
    * I agree to the terms and conditions specified above.

    User Verification

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