The following waiver is required to complete Kimray's Credit Application. You must fill out the information below in order to be eligible for credit with Kimray Inc. By completing this form you are giving Kimray Inc. the authorization to obtain a reference from the financial institution associated with your account.
I have the authority on behalf of my (our) organization to be bound to the Terms and Conditions of Sale for Kimray Inc., and that I have read and agree to be bound by those terms. The information above has been carefully read by the undersigned and is, to my knowledge, in all respects complete, accurate and truthful. It discloses to Kimray Inc. the true state of my (our) financial condition as of the day of submission. Since that time there has been no material unfavorable change in my (our) financial condition, and if any such change takes place I (we) will give notice.
You must sign your application in order to submit.
To submit your application, type your name below, then sign with your mouse and click "Save Signature".
Please use your mouse to sign the box below