New Account Application

Ship To Address (if different than bill to):
Ship to Address*
Company Name Address Line 2 City State / Province / Region ZIP / Postal Code Country
Are there additional ship to addresses?*
- No
- Yes (please list below)
Secondary Ship to Address*
Company Name Address Line 2 City State / Province / Region ZIP / Postal Code Country
Purchase Order Contact Information:
P.O. Contact Name*
P.O. Contact Title*
P.O. Contact Email*
P.O. Contact Phone*
P.O. Contact Fax*
Shipping Information
Email address to receive order tracking information*
Contact Name*
Contact Title*
Select Your Preferred Shipping Method*
- PRE PAY AND ADD TO INVOICE UNDER DOWN INC. SHIPPING ACCOUNT - Our shipping account is contracted for our product to give you the best pricing available
- YOUR UPS / FEDEX ACCOUNT
UPS Account Number*
Fedex Account Number*
Special Shipping Instructions:*
Provide a Copy of Your Sales Tax Certificate
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*

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Payment Method
Choose Payment Method*
- Credit Card
- Net 30 Application
CONGRATS!
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 yourfirst order.

3 easy ways to provide your confidential credit card information:
1. SECURE ONLINE ORDERING: EASY... Submit credit card information upon check-out. Done.
2. 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
3. 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*

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NEW ACCOUNT APPLICATION FORM