New Customer Credit Application
Owner or Management Info
Legal Business Name:
*
Business Email
*
example@example.com
Business Phone Number
*
Please enter a valid phone number.
Business Fax Number
Please enter a valid phone number.
Address Info
*
Address
City/State
Zip Code
Shipping
Mailing
Billing
Property Type
*
Multifamily
Hospital
Education
Government
Commercial
Other
Total Properties Owned/Managed
Federal Tax ID #
*
Years In Business
W9 Form
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Sales Tax Exempt (If Yes, Exemption Cert Must be Attached)
*
Yes
No
Sales Tax Exempt Form
Browse Files
Drag and drop files here
Choose a file
Cancel
of
A/P Contact
*
A/P E-Mail
*
example@example.com
A/P Fax Number
Please enter a valid phone number.
A/P Phone Number
*
Please enter a valid phone number.
PRINCIPAL/OFFICER
Title
Name
City/State
Phone Number
BANK REFRENCE
Account Type
*
Checking
Savings
Loan
Account Number
*
Bank Name
*
Bank Address
*
Branch Name
Street Address
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Fax Number
Please enter a valid phone number.
Bank Contact
*
First Name
Last Name
Bank Contact Email
*
example@example.com
TRADE REFERENCE
For Hardware, Maintenance/Building Supplies, Paint etc. Please exclude Utilities & Services
Company Name
*
Phone Number
*
Please enter a valid phone number.
Fax Number
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Account Name
*
Account #
*
Contact Name
*
Contact Email
*
example@example.com
3rd Party Ordering /Billing
*
RealPage/OPS
VendorCafe/Yardi
VendorAccess/Entrata
Nexus
Coupa
None
Other
3rd Party Compliance Portal
*
RealPage/OPS
VendorCafe/Yardi
VendorAccess/Entrata
Nexus
Coupa
None
Other
COI needed? If so, included sample or certificate holders name and address
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Terms of Payment
Invoices are due 30 days from the invoice date. A minimum charge of $2.00 or 1.5% per 28-day cycle, 18% per year, may be charged on the past due invoices. I hereby certify that the information contained herein is complete and accurate. This information has been furnished with the understanding that it is to be used to determine the amount and conditions of the credit to be extended. Furthermore, the undersigned also authorizes all creditors/banks to accept a photocopy of the signature and release credit information to Direct Supplies Warehouse, Inc.
Type
*
Management Company Principal
Property Owner
Property Manager
Other
Signature
*
Date
*
-
Month
-
Day
Year
Date
Name
*
First Name
Last Name
Title
*
Multiple Property List
Purchase Order Required
*
Yes
No
Call for New PO (if backordered)
*
Yes
No
Multiple Property List
*
Browse Files
Drag and drop files here
Choose a file
Please Include the following info: Property Name, Property Address, City, State, Zip code, Total Units, Contact info Including Property Manager Name & Email, Maintenance Manager Name & Email.
Cancel
of
*
“By providing a telephone number and submitting the form, you are consenting to be contacted by SMS text message and agreeing to our Privacy Policy. Message frequency may vary. Message and data rates may apply. Reply STOP to opt out of further messaging. Reply HELP for more information."
Privacy Policy
Continue
Continue
Should be Empty: