New Customer Set-Up

    New Customer Setup

    Customer Name * :

    State Sales Tax ID NUMBER * :

    If non taxable please attach completed Certificate. Only PDF *

    Business Start Date * :

    Website * :

    Physical Address * :

    Accounts Payable Address * :

    Main Phone Number * :

    Main Contact Name * :

    Contact Email * :

    POs Required?:

    Accounts Payable Phone Number * :

    Accounts Payable Contact Name * :

    Accounts Payable email for invoices * :

    Credit Requested:

    Terms Requested:

    Company Officers Name and email * :

    Bankruptcies, Lawsuits? * :

    BANK Reference INFO

    Bank Name * :

    Bank Address:

    Bank Officer:

    Bank Phone * :

    Bank Email * :

    Please provide 2 TRADE REFERENCES

    Company 1 Name * :
    Phone Number * :
    Contact Name * :
    Contact Email * :

    Company 2 Name * :
    Phone Number * :
    Contact Name * :
    Contact Email * :