Business Term Agreement Application Please fill out the form below which will authorize your account to be setup under term agreement, meaning, you can now use the pay-by-invoice feature with our business. NET 30 terms will be extended to you and you will be invoiced using our electronic invoicing system for all future orders. Upon approval your account will be created and applied automatically. By filling this form out, you agree that if your terms are not met, we can use the information on your provided Voided check to deduct funds directly from your bank account. Business Name:*Doing Business As (DBA):Company Website*Number of Employees*Qualifying accounts must have at least 5 employees. FEIN*Email* Billing Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Do you have an Accounts Payable Department?*YesNoQualifying applicants must have an accounts payable department. The accounts payable department cannot be the same person as the owner or manager, and must be it's own department entity.Accounts Payable Contact Name:*Accounts Payable Email:*Accounts Payable Phone*Type of Business*Sole ProprietorCorporationLLCPartnershipYear Business Established*Qualifying accounts must be in business for at least 3 years. Annual Gross Sales Revenue*Annual Gross Revenue must be over $250,000Printing Annual Approximate Budget*Front of Voided Check Upload*Please upload the front of a voided check here.