CREDIT APPLICATION FOR DIRECT BILLING STATUS

Americas Best Value Inn

1214 S. Washington Street
Junction City, KS 66441
Phone: (785) 238-7887 Fax: (785) 238-8774

Company Name __________________ Phone Number ___________________ Fax Number ______________________

Billing Contract _________________ Phone Number ___________________ Fax Number ______________________

Email Address __________________________________________

Company Address _________________________________ City _______________ State ______ Zip ______
Type Of Business __________________________ Approx. Annual Room Nights ______________

PARTNERS or CORPORATE OFFICERS

Name ________________________ Title ______________________ Phone Number _________________
Name ________________________ Title ______________________ Phone Number _________________
Name ________________________ Title ______________________ Phone Number _________________

BANK REFERENCES
Bank Name _______________________ Bank Address _______________________________________
Bank Contact Official ________________________ Phone Number __________________
Bank Name _______________________ Bank Address _______________________________________
Bank Contact Official ________________________ Phone Number __________________

TRADE REFERENCES
Name _______________________ Phone Number ______________________
Name _______________________ Phone Number ______________________
Name _______________________ Phone Number ______________________

APPLICATIONS SIGNATURE ATTESTS FINANCIAL RESPONSIBILITY, ABILITY & WILLINGNESS TO PAY INVOICES IN ACCORDANCE WITH
TERMS BELOW:
Should this application be approved, I (we) agree to pay our invoices to Americas Best Value Inn of Junction City, KS within 30 days
of the date of the invoice. In the event an invoice is not paid, a late charge of $25 every 30 days may be assessed for all amounts
over 30 days past due. Should this amount become delinquent or unpaid, I (we) agree to pay all reasonable attorney fees and
collection costs related to collection and enforcement of these terms.
The above information is for purposes of obtaining credit and is warranted to be true. I (we) authorize Americas Best Value Inn of
Junction City, KS to inquire and/or obtain from any credit bureau or reference, whether listed on this application or not, any
information relating to my (our) credit worthiness.
Signature _________________________________________________ Date ____________________________
Print Name _______________________________________________ Title ___________________________