Credit Terms Application

Store Phone *

(###)

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Fax

(###)

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Company Type *

Proprietorship

Partnership

Corporation / LLC

Date Established *

MM

DD

YYYY

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Has the firm or any of its principals ever filed for bankruptcy *

No

Yes

Billing Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Preferred Terms (Final terms to be reviewed and approved by credit team) *

Net 30

Credit Card

Pre-Paid

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Bank Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Bank Phone *

(###)

###

####

Bank Fax

(###)

###

####

Fax

(###)

###

####

Fax

(###)

###

####

Fax

(###)

###

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Terms and Conditions *

For the purpose of inducing Urban Outfitters Wholesale, Inc. to extend credit, each individual signatory hereto represents that the information herein has been personally verified and is true and correct in all aspects; the applicant has sufficient assets to satisfy all anticipated liabilities, and Urban Outfitters Wholesale, Inc. will be notified in writing of any actual or suspected tangible changes in the financial condition of the applicant. Furthermore, in consideration for the benefits which may accrue to the individual signatories hereto by Urban Outfitters Wholesale, Inc. extension of credit to the applicant, each individual signatory irrevocably agrees to serve as the absolute and unconditional guarantor and surety for all obligations and liabilities of the applicant incurred from the date of the signature hereto, notwithstanding any extension, forbearance or modification of the same. It is also agreed that the applicant (and the individual signatories as guarantors and sureties) shall be liable for all costs, expenses and attorney’s fees incurred by Urban Outfitters Wholesale, Inc. in connection with this account, and its authorized agent, are hereby authorized to make inquiries as it deems fit and proper regarding applicants credit history, including but not limited to inquiries directed to those references identified in this application. I authorize the noted bank reference to release all information on the listed account(s) to URBAN OUTFITTERS WHOLESALE, INC for the purpose of establishing credit terms with them. If you are purchasing Free People products with a credit card, you agree that, upon Free People’s acceptance of your order, Free People may charge your credit card for the full cost of your order plus shipping. You further agree that risk of loss on products you order will shift to you upon Free People’s delivery of those products to a carrier at Free People’s distribution or fulfillment center, and that you will pay shipping costs from Free People’s distribution or fulfillment center to you.

Date *

MM

DD

YYYY