445 Winnipeg Street, Regina
Saskatchewan, S4R 8P2
Tel (306) 546-5444
Fax (306) 546-5555
Toll Free 1-877-305-0029
E-mail  Sales@independentschoice.com

   
Credit Application / Personal Guaranty
    

In order to induce Independents Choice Distribution to extend credit to
(Company Name):  __________________________________________ 

The undersigned being the Principle Shareholders of (Customer Signature):
 _________________________________________________________ 

Hereby jointly and severally unconditionally guarantee the payment of all 
sums which may be or become due for merchandise sold and delivered to 
(Company Name):  __________________________________________

It is understood that this is a personal guarantee which shall be governed by
the laws of the province of Manitoba/Saskatchewan/Ontario and which shall
be effective despite any renewal modification, or waiver by Independents
Choice Distribution or any of (Customer Signature):___________________

Obligations, and no such modification, renewal, or waiver shall operate to
defeat or affect this guarantee

Signature: ____________________ Name (Print): ___________________

Signature: ____________________ Name (Print): ___________________

Witness:  _____________________ Name (Print): ___________________

I/We understand and agree to the credit terms of sales as stated on each
invoice and to the conditions designated by Independents Choice Distribution. 
I/We understand and we agree to pay interest on all past due amounts at
the rate of 2% per month or 24% per annum.

Signature: ____________________ Name (Print): ___________________

Signature: ____________________ Name (Print): ___________________

Witness:  _____________________ Name (Print): ___________________