New Customer Application New Customer Application Application Information Date Completed Touch Sales Rep (If Known) Form Completed By First Name Last Name Email Address Requested Account/Payment Method Prepaid Credit Card ACH/eCheck Open Account (credit approval required) Company Information Legal Company Name DBA/Trade Name Entity Type Select… Corp. LLC Partnership Sole Prop. Federal EIN – Business License No. Website Type/Nature of Business Select… Years in Business No. of Employees Addresses Billing Address Address Line 2 (Optional) City State Zip Code Country Shipping address is the same as billing address Shipping/Shop Address Address Line 2 (Optional) City State Zip Code Country Primary Contacts and Communication Preferences Owner / Principal First Name Last Name Email Address Phone Number Email Use Orders Invoices Purchasing First Name Last Name Email Address Phone Number Email Use Orders Invoices Accounting First Name Last Name Email Address Phone Number Email Use Orders Invoices Business Profile & Sales Tax Information Products you are interested in purchasing (Select Categories) TOUCH KICK-STEPDRAWER SYSTEMSMETAL DRAWER SYSTEMSDOUBLE-WALL DRAWER SYSTEMSLIM DRAWER BOX SYSTEMREAR BRACKETS & ACCESSORIESSIDE MOUNT DRAWER SLIDESFULL EXTENSION SIDE MOUNT SLIDESHEAVY DUTY SIDE MOUNT SLIDESPUSH-OPEN SIDE MOUNT SLIDESPUSH-OPEN SOFT CLOSE SIDE MOUNT SLIDESSOFT CLOSE SIDE MOUNT SLIDESUNDERMOUNT DRAWER SLIDESPUSH-OPEN SOFT CLOSE UNDERMOUNT SLIDESPUSH-OPEN UNDERMOUNT SLIDESSOFT CLOSE UNDERMOUNT SLIDESSTANDARD DUTY UNDERMOUNT SLIDEST-MOTION SOFT-CLOSE UNDERMOUNT SLIDESCABINET DOOR LIFT SYSTEM AND LID SUPPORTCABINET DOOR GAS SPRING STRUT LIFTCABINET DOOR LID STAYCABINET DOOR LIFT SYSTEMHINGE SYSTEMSANGLED CABINET HINGESBLIND CORNER CABINET HINGESCOMPACT CABINET HINGESMOUNTING PLATES &ACCESSORIESPUSH OPEN CABINET HINGESSTANDARD CABINET HINGEST-X SERIESWIDE ANGLE CABINET HINGESTOOLS & SUPPLIESHAND TOOLSTOOL BAGS & BELTSWOODWORKING JIGSOFFICE SUPPLIES Other products Note Current Wholesale Suppliers How did you hear about TOUCH? Estimated Monthly Purchases Sales Tax Status Purchases are subject to sales tax Purchases are for resale/tax-exempt Seller’s Permit/Resale License No. Issuing State/Jurisdiction Required Supporting Document Resale/exemption certificate attached W-9 attached Requested Account Setup Purchase Order Requirements/Special Instructions Preferred Order Method Phone Web Email Invoice Delivery Email Other Submit Application
