REQUEST FOR GROWER INFORMATION
WALLA WALLA FARMERS CO-OP
The undersigned respectfully submits the application for the credit extension described below:
Social Security Number
Federal ID #
Type of Organization
Corporation General Partnership Limited Partnership Sole Proprietorship Individual Other
Purpose of Credit Application
Farm or Machine Shop Account Fuel Cards Cell Phone
Balance Sheet: Complete in detail or attach current financial statements. C-Card = "Credit Cards" Please Provide Us With Loan & Creditor Information: Attach Separate Sheet if necessary.
Name & Location of Bank or Creditor:
List Loan or Account Numbers if you have any:
List Monthly Payments if you have any:
Monthly Payments 00
Monthly Payments 01
Monthly Payments 02
Monthly Payments 03
Balance Owing if you have any:
Balance Owing 00
Balance Owing 01
Balance Owing 02
Balance Owing 03
Have you individually or as a part of any entity ever filed for bankruptcy?
Walla Walla Farmers Co-op
Credit Policies Annual Percentage Rate (APR) & Periodic Percentage Rate: 18% APR Monthly periodic rate is determined by dividing
the Annual Percentage Rate (APR) by 12. Periodic (monthly) Percentage Rate is 1.5%, (or $1.00 whichever is greater).
Due Date and Grace period for the payment of the Balance for Purchases: Monthly statements will be mailed on
approximately the 5th day of each month. Payment in full is due by "due date" which is the 15th of the month of such
mailing. All payments made on account will be first applied toward the payment of petroleum purchased. There will be a
discount offered on certain commodities if payment is received in full by the 15th. You have a Grace Period until the last
day of the month of billing to pay the entire balance of your account without incurring any finance charges. If you pay in
installments, you must make the minimum monthly payment by the end of the monthly grace period.
Method of Computing the Interest: The periodic Percentage Rate of Interest (1.5% per month or $1.00 whichever is
greater) will be applied to the remaining unpaid balance in your account (if any) after the last day of each month. The
monthly finance charge, as applied to the balance on the last day of the previous month, will appear in the billing
statement mailed by the 5th of the month.
Minimum Monthly Payment: 1/12 of the total amount due or $35, whichever is more.
A $20 late charge will be assessed if the minimum monthly payment is not received during the
monthly grace period.
Late Payment Fee:
Return Check Fee: If your check for payment is refused twice by the issuing bank, your account may be charged with a
service fee for the NSF check in the amount of $40.00 or the face value of the check, whichever is less.
Credit Reactivation Fee: If your fuel card or cell phone is deactivated for failure to make full and timely payments, there
will be a $20 reactivation fee to reactivate the fuel card or cell phone after the default is corrected.
Credit Limit: Upon approval of your application for credit, Walla Walla Farmers Co-op, Inc. ("the Company") will establish
a credit limit on your account. Your credit limit will appear on your monthly statement. At our discretion, the Company
may change your credit limit at any time. The Company will notify you if we do, either by mail or through your monthly
billing statement. You may request a change to your credit limit by contacting the Company by telephone or mail.
Equal Credit Opportunity Act Notice: The federal Equal Credit Opportunity Act prohibits the Company from
discriminating against credit applicants on the basis of race, color, religion, national origin, sex, martial status, disabilities
or age (provided the applicant has the capacity to enter into a binding contract); because any of the applicant's income is
derived from any public assistance program, or because the applicant had in good faith exercised his or her rights under
the Consumer Credit Protection Act.
Event of Default; Remedies: Failure to make full and timely payment of your account by the end of the Grace Period
(end of the month), your filing for bankruptcy protection or seeking other similar protection (such as an assignment for
benefit of creditors), insolvency, exceeding your credit limit without prior written approval of the Company management, or
breaching this agreement with the Company constitutes a default with or without further notice to you. On default and
without prior notice to you, the Company reserves the right to close your account to new purchases, to terminate all credit
privileges pending review of your account by the Company, and to take any necessary legal action to collect on the
account or to otherwise enforce the agreement.
If the Company terminates all of your credit privileges, all subsequent sales will be by cash only unless prior arrangements
have been made with the Company. The Company immediately will terminate gas card privileges at the pump for
accounts that are in such default unless prior arrangements have been made with the Company.
You agree that the Company has the right to take any necessary action to collect an account that is in default including,
but not limited to, action taken by an attorney such as by filing a court action (e.g., an action in any court of appropriate
jurisdiction), filing an appeal, foreclosure of a security interest, or action by a professional collection agency. Reasonable
attorneys fees and costs incurred will be awarded to the substantially prevailing party on any action to collect on the
Any disputes arising under the Company's credit polices are subject to the jurisdiction of the courts for the State of
Washington; venue is in Walla Walla County, Washington. Washington law applies to the interpretation of this
Authorization for Credit Inquiries
I/We, the undersigned, authorize Walla Walla Farmers Co-op to make any credit inquiries it deems necessary on my/our
account(s). Specifically, I/We authorize release of the following information: (TO BE COMPLETED BY LENDER)
Operating Line of Credit: Average Balance
Total Available Line
Operating Checking Account: Average Balance
Term and Other Loans: Description:
Are Loans paid as agreed?
Yes No If no explain
Authorized Applicant Signature
Notice of Right to Request Specific Reasons for Credit Denial (for Business Credit)
If applying for business credit, and if your application for business credit is denied, you have the right to a written statement of the
specific reasons for the denial. To obtain the statement, please contact the Credit Dept. as shown below within sixty (60) days from the
date you are notified of our decision:
Walla Walla Farmers Co-op, Credit Dept., PO Box 928, Walla Walla, WA 99362
Phone (509) 525-6690
We will send you a written statement of reason for the denial within thirty (30) days of receiving your request.
APPLICATION AGREEMENT AND SIGNATURES
I/We certify that the information provided in the application is true and correct, and I/we authorize Walla Walla Farmers Co-op
(“the Co-op”) to make or have any credit, employment or investigative inquiries it deems necessary for the extension of credit and the
collection of any amounts owing. The Co-op is also authorized to furnish information about my/our account to consumer reporting
agencies and other agencies who may properly receive that information. If the applicant is an entity, I hereby confirm that I have the
authority to sign this Application and Agreement on its behalf and that my signature will be all that is necessary in order for this
Application and Agreement to be binding on such entity. If the Co-op has to refer the account for collection to an attorney or take any
other action concerning this Application and Agreement, I/we will pay to the extent permitted by law with or without suit and upon
appeal, all reasonable attorney fees and court costs incurred by the Co-op.
By my/our signature(s), I/we acknowledge that this Agreement is the full agreement between myself/ourselves and the Co-op
and that the Agreement is fully integrated and incorporates all of the Co-op’s credit policies, as now written or as they may be
subsequently amended. It is further acknowledged and agreed that the terms are severable such that the invalidity of any one term
does not affect the remaining terms of the Agreement, and that any disputes arising under this Agreement are subject to the jurisdiction
of the courts for the State of Washington and that venue will be proper in Walla Walla County, Washington. Washington law applies to
the interpretation of this Agreement.
I/we am/are applying for a Cardtrol Operating Card, and if I/we subsequently qualify, I/we agree to be bound by the terms of
the Cardtrol Operating Card Agreement and Disclosures which are available and will be forwarded to me.
Name of Commercial Applicant
Authorized Agent or Employee of Commercial Applicant
(Typed name and title of signatory)