Application is hereby made and the following references given. It is understood this information will be held in the strictest confidence and used only by our credit department. Please note: UNTIL CREDIT IS ESTABLISHED, ALL NEW ACCOUNTS MUST PREPAY ADVERTISING. The advertising agreement form must be completed and returned in 10 days to establish account credit before ad is to run.

Personal Info:

[  ] Corporation [  ] Partnership [  ] Proprietorship (1) Owner                                                                         Name __________________________ Title __________ Home Address _________________________________ Town _______________________ Phone____________ Zip ___________ Fed. or Soc. Sec. # ________________ (2) Second Owner (if applicable): Name __________________________ Title___________ Home Address _________________________________ Town _______________________ Phone____________ Zip ___________ Fed. or Soc. Sec. # ________________

Local Branch Bank, Account Type, & Location ___________________________________________________________ ___________________________________________________________ 3 Local Trade References & Phone #s 1. ________________________________________ 2. ________________________________________ 3. ________________________________________ Additional Comments: ___________________________________________________________ ___________________________________________________________ ___________________________________________________________

I, we personally guarantee payment of all charges for services rendered by Niagara Frontier Publications plus carrying charges of 2% (24% annual rate) on past due balances, together with attorney's fees for collection of any and all delinquent balances pertaining thereto. TO MAINTAIN DISCOUNTS ON ADVERTISING, EACH MONTH'S BILLING MUST BE PAID IN FULL WITHIN 10 DAYS OF BILLING WITH NO BALANCE DUE. IF FREQUENCY DECREASES DURING ANY PERIOD, DISCOUNT WILL BE LOST AND CHARGE BACK; IF FREQUENCY INCREASES DISCOUNT WILL BECOME RETROACTIVE AND CREDITED. We understand your terms and agree to abide by them. Renewal: Contract automatically renewed from year to year unless party gives 30 days written notice before end of term. All terms will apply as per advertising rate card.
 

____________________________________________________________________________________________________________________ Authorized by (please print)                                                                      Title                               Date ____________________________________________________________________________________________________________________ Authorized by (please print)                                                                      Title                               Date ____________________________________________________________________________________________________________________ Account Representative                                                                            Title                               Date