Account Setup Form

LICENSEE INFORMATION

ENCRYPTED SECURITY
CONTACT NAME

First NameLast Name
COMPANY
AGCO NUMBER
EMAIL ADDRESS
USED FOR BILLING / DELIVERY CONFIRMATION
DELIVERY ADDRESS

Street Address

Street Address Line 2

CityProvince

Postal Code
DELIVERY NOTES (OPTIONAL)
UPLOAD DOCS (OPTIONAL)

Cancelof
ACCOUNT NOTES (OPTIONAL)
PAYMENT INFORMATION
PAYMENT TYPE
PAYMENT TERMS
A MEMBER FROM OUR ACCOUNTING TEAM WILL BE IN TOUCH ON THE NEXT BUSINESS DAY TO COLLECT CREDIT CARD INFORMATION. ORDERS WILL NOT BE PROCESSED UNTIL THE CREDIT CARD INFORMATION IS RECEIVED OR TERMS ARE ESTABLISHED.
CREDIT CARDS WILL BE PROCESSED AT THE TIME OF ORDERING AND AN EMAIL RECEIPT WILL BE ISSUED. CREDIT CARD AUTHORIZATION REMAINS IN EFFECT UNTIL A REQUEST TO CANCEL IS RECEIVED.
SIGNATURE
Should be Empty:

LICENSEE INFORMATION