New Customer Form Please remember to submit the following form once you are complete. If you have any questions, do not hesitate to reach out to customer service at 800.635.6779 or firstname.lastname@example.org If you would like to download this form instead, please click here. Company Information Form of Business Ownership CorporationPartnershipIndividualLimited Liability Company Accounts Payable Information Sales Info Tax Information Sales tax will be added to invoices for shipments into California, Illinois, and Washington, unless customer is either a Reseller or Tax Exempt. Is Customer a Reseller? YesNo If yes, provide Resale Certificate for each applicable state. (Seller's Permit does not meet requirement for deferring sales tax.) Is Customer Tax Exempt? YesNo If yes provide Tax Exemption Document Bill To Address Ship To Address Same as "Bill To"? If yes, go to next section. Principle(s) Bank Reference Credit References If you are using a credit card, please skip down to the next section. Credit Card Information ~ Only needed if you intend to use your Credit Card ~ If the billing address for the Credit Card differs from the address you provided above (in section 5), please complete below. Credit Card Billing Address This application is for the purpose of extension of credit following terms and conditions of the seller. All information will be held in the strictest of confidence. Please use your full name in the digital signature.