10151 Stella Link, Houston TX 77025
Please Fax back to 713-662-5542

CASH ACCOUNT APPLICATION

Legal Name of Firm
Mailing Address 
City      State     Zip Code
Street / Delivery Address
City      State     Zip Code
Phone     Fax
Owner Name     DL#     DOB
Please attach copy of:  EPA Card
Texas only, please attach one of the following:
TACL    State Certificate of Registration    Municipal License    ODC Permit (Austin Only)

Type of Business: Check all that apply

A/C & Htg. Res. Replacement  A/C & Htg Res. New Const.A/C & Htg Comm.Geothermal Refrigeration
Sheet Metal  Building Maint. Apt. Maint. IndustrialInstitutionalComm. Controls International Export
Electrical Serv. Plumbing Serv. Modular Manufacturer Other 

Certificate of Exemption

The undersigned purchaser hereby certifies to you that:

1. Purchaser holds a valid permit; number issued under the
   limited sales & excise & use tax of the State of      , City of     
County of  , Parish of     .

2. The tangible personal property purchased on each order for Air Conditioning, Refrigeration &  Heating parts & supplies heretofore
give you and on each order that we shall herafter give you, unless such order other wise specified.  And until this date and certification
is revoked by us in writing, is hereby purchased for resale.

3. The undersigned purchaser further certifies that He will assume liability for the transaction is
    not exempt from such tax.

Date       Signature ________________________________________
Purchaser    Title  Address

I understand that the information furnished on this application is warranted to be true.                         
___________________________________                    ____________ 
                          Owner Signature                                         Date

Office Use Only

Office Approval _______________      Declined by  ____________   Date _____________   Account # ____________   Sales Class _________   Salesperson ___________