short description short description
CORPORATE ACCOUNT FORM

Contact Name * Tel *
Company Name * Tel *
Billing Address * Fax *
Type of Company (check one) Corporation Partnership Individual
How Long in Business? Taxable? Tax Exempt #
Principals Information
Name Address Title
Name Address Title
 
Bank Name Address
Bank Account # Manager Tel
Trade References:
Name Address Tel
Name Address Tel
Name Address Tel
I understand that all purchased service and merchandise will be billed on a monthly basis and payment is due within 30 days.



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