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Fill out and return our application with your current state medical/pharmacy license to get started today.

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I hereby certify that the above information is correct. I agree to pay and authorize charges to my card for all open invoices. The information included in this credit application is only for the use of Astor Drugs, Inc Terms: All invoices are required to be paid within terms assigned unless specifically indicated on the invoice. By signing this application, the undersigned, acting as an agent and on behalf of the Customer, has authority to commit Customer to pay all bills incurred by Customer in a timely fashion as outlined by the terms described on each invoice. Further, the Customer agrees that in the event it becomes necessary for Astor Pharmaceuticals LLC (Astor) to incur collection costs or institute legal action to enforce rights arising out of an Invoice or a Purchase Order, the Customer agrees to pay such additional collection costs, interest at the rate of Eighteen Percent (18%) per annum or the maximum rate allowed by law, whichever is greater, and reasonable attorney’s fees. The Customer waives all rights of set off, rights to a trial by jury, and consents to the jurisdiction of the State of New York, for resolution of all disputes. The Customer warrants that the above information is true and correct and authorizes Astor to conduct a credit investigation on behalf of Customer to include all references and credit reports. The undersigned individuals hereby consent to Astor use of a non-business consumer credit report in order to further evaluate the credit worthiness of the undersigned individuals as a principal or guarantor in connection with the extension of credit and further authorize Astor to utilize a consumer credit report on the undersigned individuals from time to time in connection with the extension of credit contemplated by this application and knowingly consents to the use consistent with all federal, state and local laws, including 15 USC Section 1681, et.seq. The undersigned individuals herby guarantee the prompt and full payment of all indebtedness of Customer, including all costs and reasonable attorney’s fees necessary for collection and enforcement of this guarantee. The obligations of the undersigned individuals shall be primary and not secondary to Customer. This guarantee shall be a continuing and irrevocable guarantee and indemnity for the indebtedness of the Customer. The undersigned individuals waive all notice of default, nonpayment and notice thereof, waive all rights to a trial by jury, and consent to any modification or renewal of the credit agreement hereby guaranteed and consent to the jurisdiction of the State of New York, for resolution of all disputes.

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