AR Request Form

AR Request Form

Used to request assistance from accounting
Your Name*
Your Email*
example@example.com
Your Department*
Request Type*

Account ReactivationRebillInvoice OnlyStatement RequestEmail update for invoicesPrice AdjustmentUPS Claim DocumentationCredit Hold Inquiry
Account Reactivation

Used to reactivate an account.
Before this form is submitted ensure that you have checked that there isn't any duplicate account information.
Customer Name
Customer Email
example@example.com
Account Number
Reactivation Reason

Pending OrderOther
Is this a prepay account?

YesNo
Contact the Credit Department.
Credit Application

Browse Files

Cancelof
Rebill Request

Use when order needs to be billed to a different account number.
Please credit:
Original Account #
Original Order #
Invoice #
Original $ Amount
Please rebill:
New Account #
New Order #
Rebill $ Amount
Reason for rebill
Price Adjustment

Used when a price needs to be adjusted on an invoice.
Customer Number
Invoice Number

Invoice Only

Used to invoice an order without shipping product.
Order Number
Reason for Invoice Only
Statement Request

Used to send a Statement to a customer.
Account Name
Account Number
Email Address to send statements to:
example@example.com
Electronic Invoice Email update
Account #
Account Name
Email address(es) to add
example@example.com
Email address(es) to add
example@example.com
Email address(es) to remove
example@example.com
Email address(es) to remove
example@example.com
Is the customer expecting a refund?*

YesNo
UPS Claims Documentation

Used to submit UPS Claim documents to Receivables
Customer #
Original Order #
UPS Claim Documents:

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Cancelof
Credit Hold Inquiry
Customer #
Order #
Nature of Credit Hold Inquiry:
Freight Only Credits
UNTIL FURTHER NOTICE AN RMA WILL BE REQUIRED TO PROCESS A FREIGHT ONLY CREDIT. IF AN RMA IS NOT INCLUDED THE REQUEST WILL BE REJECTED.
Customer Number:
Customer Name/Account Name:
If Guest account please use customer name.
Order Number:
RMA Number
Invoice Number:
Amount of Credit:
Payment Method:
For INTL orders, need copy of duties invoice

Browse Files

Cancelof
Detailed Reason for credit:
Comments to AR regarding request:

Account Reactivation