NEW ACCOUNT APPLICATION FORM

Please fill out this form in its entirety

"*" indicates required fields

About Your Business

Business Name*

Billing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Business Phone Number*

Business Fax Number

Email*

Company Website

Main Contact*

First Last

Job Title*

Type of Business*

Retail Store Front

Web Sales Only

Designer - Commercial Location

Designer - Home Based

Workroom - Commercial Location

Workroom - Home Based

Hotel

Other

Inventory*

Will you stock inventory or will products be drop-shipped to your customers?

Stock Inventory

Dropship to Customer

Other

Type of Entity*

Corporation

Partnership

Sole Proprietor

Business Opening Date*

Provide a Copy of Your Sales Tax Certificate

Sales Tax ID#*

Certificate submission options*

Upload a Copy

I will email a copy to: customerservice@downinc.com

I will fax a copy to: 616-452-1255

Upload Sales Tax Certificate*

Max. file size: 50 MB.

Shipping Information

Shipping Information Contact*

Same as Main Contact

Separate Contact

Contact Name*

Contact Title*

Email address to receive order tracking information*

Shipping Contact Phone #*

Ship To Address (if different than bill to):

Ship to Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Are there additional ship to addresses?*

Yes (please list below)

Secondary Ship to Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Select Your Preferred Shipping Method*

Add to invoice (Default)

YOUR UPS ACCOUNT

YOUR FEDEX ACCOUNT

Account Number*

Special Shipping Instructions:

Purchase Order Contact Information

Purchase Order Contact*

Same as Main Contact

Separate Contact

P.O. Contact Name*

P.O. Contact Title*

P.O. Contact Email*

P.O. Contact Phone*

P.O. Contact Fax

Payment Method

Choose Payment Method*

Credit Card

Net 30 Application

Person to contact for payment of invoices:

Invoice Payment Contact*

Same as Main Contact

Separate Contact

Contact Name*

Contact Title*

Email Address*

Contact Phone*

You have chosen to set up your new account as Credit Card payment. Payment method is not required to set up an account, but will be required when placing your first order.

3 easy ways to provide your confidential credit card information:

SECURE ONLINE ORDERING: EASY... Submit credit card information upon check-out. Done.
VIA EMAIL/FAX: A FEW MORE STEPS, but still simple. Before ordering remember to:
- Download Credit Card Authorization form
- Save
- Fill-out
- Email back to: customerservice@downinc.com
VIA PHONE: Yes, we still talk to customers daily! If you love chatting with a "real" person just call & tell us your CC#.

Net 30 Day Terms Application

Company Name*

Date Applied*

Contact for Additional Information*

Contact's Phone Number*

Contact's Email*

References

Please provide 3 references that you have done business with in the last five years.

Reference 1

Company Name*

Email Address*

Account Number*

Phone Number*

Fax Number*

Year Account Opened*

Reference 2

Company Name*

Email Address*

Account Number*

Phone Number*

Fax Number*

Year Account Opened*

Reference 3

Company Name*

Email Address*

Account Number*

Phone Number*

Fax Number*

Year Account Opened*

Legal

We certify that the above information is true and correct to the best of our information, knowledge and belief. We agree to pay all charges according to the terms and conditions as stated by DOWN inc. ("Creditor"). If we fail to do so, then we agree to pay any late charges, reasonable collection costs and attorney fees if collection procedures are instituted. Should credit availability be granted by Creditor, all decisions with respect to the extension or continuation of credit shall be at sole discretion of Creditor. Creditor may terminate any credit availability within its sole discretion.

We authorize you to conduct an investigation of our credit worthiness, including but not limited to securing commercial credit reports, consumer credit reports, trade references, lender references, lease references.

We hereby authorize release of credit information to DOWN inc.

Print Name*

Authorized Signature*

*E-Signature accepted as your full authorization.

Title / Position*

Date*

Additional Information

Do you have a sales rep?

Yes

Who Is Your Sales Rep?*

How Did You Hear About Us?*

Google/ Bing/ Yahoo, etc.

Trade shows

Industry publications

Social Media (Facebook, Instagram, LinkedIn)

Other

Please Specify:

Phone

This field is for validation purposes and should be left unchanged.