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Company Information
Last Name
First Name
Middle Initial
Company Name
In Business Since:
Title
FEIN Tax ID
Current W-9
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Billing/Mailing Address
State
Zip
Shipping Address
State
Zip
Phone
Legal Form Under Which Business Operates
Company Officer/Owner
Name/Titles
Email
Address C/S/Z
DOB
SS#
Billing Contact
AP Phone
AP Email
Web Address
Terms / Sales Tax / Purchase Order Setup
Terms:
NET 30
Net Terms Other
COD
Credit Card
Sales Tax Exempt
Yes
No
Attach Current Copy Of Sales Tax Exempt Certificate
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Order Instructions
Show Prices
Yes
No
Back Orders Accepted
Yes
No
Purchase Order #
Yes
No
Trade References - 3 References Are Required
Company 1
Company Name 1
Contact (First and Last) 1
Address 1
Phone 1
Email 1
Company 2
Company Name 2
Contact (First and Last) 2
Address 2
Phone 2
Email 2
Company 3
Company Name 3
Contact (First and Last) 3
Address 3
Phone 3
Email 3
Taylor Sales Representatives Name
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