Call 877.584.3600 Corporate Billing Corporate Billing Credit Application Client/Dealer Name (With whom are you applying for credit?) required Legal Name Trade Name Phone #1 Fax Number Phone #2 Cell Number Physical Address required State Armed Forces America Armed Forces Armed Forces Pacific Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut District of Columbia Delaware Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska New Hampshire New Jersey New Mexico New York Nevada North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Is the Mailing Address the same as the Physical Address? Mailing Address required State Armed Forces America Armed Forces Armed Forces Pacific Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut District of Columbia Delaware Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska New Hampshire New Jersey New Mexico New York Nevada North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming A/P Email Address Website County How would you prefer to receive monthly statements? Email (with invoice images) Standard Mail (without images) Business Type: Corporation LLC Partnership Sole Owner Principal Name % of Ownership Name of Parent/Holding Co/Subsidiaries/Affiliates/Franchises Have the Company or any Owners Filed Bankruptcy in Last 7 Years? Yes No Premises Owned Leased PO Required? Yes No Number of Employees Date Business Started Date Business Purchased From Previous Owner Name of Person to Contact With Any Questions Phone If Tax Exempt, List Sales Tax # Federal ID# Next 1 / 3