Company Name:*

Address:*

City:*

State:*

Zip Code:*

Country:*

Company Website:

Company Phone Number:*

Fax Number:

FEIN#:*

Type Of Business:* https://www.irs.gov/pub/irs-pdf/fw9.pdf

Corporation LLC Sole Proprietor Other

Upload W9 Form:*

1-800-E-Supply Account Number Assigned:

Vendor Contact:*

Telephone Number:*

Fax Number:

Email Address:*

Accounts Receivables Contact:*

Telephone Number:*

Fax Number:

Email Address:*

Payment Terms:*

1% 20 Days; Net 30
2% 20 Days; Net 30
Other

Payment Methods Accepted:

Credit Card ACH Check

Disclaimer: If credit card payment is selected, 1-800-E-Supply will not pay any fees associated. 1-800-E-Supply recommends you not select credit card payment if any fees are associated to avoid complications.

ACH payment method:

If you accept ACH payment method then fill the ACH information and submit.

Remit to address (if different from above):

City:

State:

Zip Code:

Country:*

Free Freight PO Amount:*

Return Policy:*

Minimum Order:*

Vendor Setup Request Form

How 1-800-E-Supply Communicates With Your Company

What 1-800-E-Supply Needs to Know:

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