New Client Information Form

Your Name Here Please:*
E-Mail:*
Business Information
Company:*
Street Address:*
City:*
State:*
ZIP:*
Main Contact:
Office Phone:
Fax Number:
Federal Tax ID Number:
Sales Tax Exempt Number (must provide certificate):
Sales Tax Exempt Certificate:
Max. file size: 64 MB.
Do You Require P.O. Numbers:
- No
- Yes
Business Type:
- Corporation
- LLC
- Partnership
- Sole Prop
- Other
Other Busyness Type:
Accounts Payable Contact
Contact:
Phone:
E-Mail:
Trade References
Company Name:
High Credit:
Phone:
E-Mail:
Company Name:
High Credit:
Phone:
E-Mail:
Company name:
High Ccredit:
Phone:
E-Mail:
Financial References
Bank Name:
Address:
Account Number:
Contact Name:
Years of Relationship:
Phone:
E-Mail:
Credit Reference Name:
Address:
Account Number:
Contact Name:
Years of Relationship:
Phone:
E-Mail:
Please Upload Your W9 Here:
Accepted file types: jpg, pdf, Max. file size: 5 MB.
Other Information
Relationship Desired:
- Long Term
- Short Term
Who is your Arizona Party Rental Contact:
Additional Notes
Notes:
Signature
I hereby authorize Arizona Party Rental to investigate the information supplied herein. I also authorize my bank, other financial institutions and suppliers of credit as listed herein to share with Arizona Party Rental their experience. Authorization is granted to use electronic copies of signatures to obtain authorization.
Signature:*
Title:*
Date:*
MM slash DD slash YYYY

Business Information