Account Set-Up Form

Account Set-Up Form

Please complete this form prior to placing any orders. You will receive confirmation of completion, and a copy of your form via email. Please allow 1-2 business days processing time if you are requesting Tax Exemption or Credit Terms.
Company/Customer Name*
Primary Account Contact*

First NameLast Name
Title / Position*
Primary Contact Phone Number*

Area CodePhone Number
Primary Email Address*
example@example.com
When order is complete, how would you like to be notified?*

PhoneEmail
Is Official Company Name the same as shown above?*

YesNo
Official Company Name*
Billing Address*

Street Address

Street Address Line 2

CityState

Zip Code
Shipping Address same as Billing?*

YesNo
Shipping Address*

Street Address

Street Address Line 2

CityState

Zip Code
Shipping Site Name/Description*
Site Phone Number*

Area CodePhone Number
On-Site Contact*

First NameLast Name
Shipping Address*

Street Address

Street Address Line 2

CityState

Zip Code
Do you have another Shipping Address to add?

YesNo
Shipping Address #2*

Street Address

Street Address Line 2

CityState

Zip Code
Shipping Site Name/Description*
Site Phone Number*

Area CodePhone Number
On-Site Contact*

First NameLast Name
Do you have another Shipping Address to add?

YesNo
Shipping Address #3*

Street Address

Street Address Line 2

CityState

Zip Code
Shipping Site Name/Description*
Site Phone Number*

Area CodePhone Number
On-Site Contact*

First NameLast Name
Accounting Contact Information
Where shall we send billing/invoices?*

Primary Account ContactAccounting ContactBoth
Accounting/AP Contact Name*

First NameLast Name
Title / Position*
Accounting/AP Number*

Area CodePhone Number
Accounting/AP Email Address*
How do you prefer to receive Invoices/Statements?*

USPS MailEmail
Account Tax Status
Do you have Resale ID/Tax Exempt Status?*

Yes, I will provide my Transaction Privilege Tax Exemption CertificateNo, I prefer my Account to be taxable
Please Upload Current AZFORM 5000/5000A (Links to each form are provided below.)*

Browse Files

Cancelof
Arizona TPT Exemption Certificate - General

Arizona Resale Certificate - Form 5000A
Requested Terms

All new accounts are COD. Based on consideration of volume and frequency of order(s), we are able to offer terms after initial orders. In many instances, even with terms, volume projects are still subject to Deposit Requirements.
Are you interested in applying for Credit Terms with USA Hall of Frames*

YesNo
Name of Principal Business Owner*

First NameLast Name
Year Founded*
Type of Business*
Bank Information
Bank Name*
Routing #*
Account #*
City, State*
References
Trade Reference #1*
Contact Name*
Phone Number*

Area CodePhone Number
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Trade Reference #2*
Contact Name*
Phone Number*

Area CodePhone Number
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState

Zip Code
All information is correct.

Yes
Should be Empty: