Online Account Application Form
 
 1:: Business
Legal Business Name*
DBA/Trade Name*
Year Founded*
Federal Tax ID*
Number of Stores*
Business Email
Business URL
Owner/Principal First Name*
Owner/Principal Last Name*
 
 2:: Account
Type of Account*:
Terms of Account*:
If you select Net 30 please enter the Reference Section at the end of this form
 
 3:: Billing
Street Address 1*
Street Address 2*
City*
State*
Zip* —
Phone*
Fax*
 
 3:: Shipping
— Same As Billing Info
Street Address 1*
Street Address 2*
City*
State*
Zip* —
Phone*
Fax*
 
 4:: Contact
Manager Information
Manager First Name*
Manager Last Name*
Manager Phone*
Manager Fax*
Buyer Information
– Same as Manager
Buyer First Name*
Buyer Last Name*
Buyer Phone*
Buyer Fax*
– Same as Manager
– Same as Buyer
– Different from Manager/Buyer
Accounts Payable First Name*
Accounts Payable Last Name*
Accounts Payable Phone*
Accounts Payable Fax*
 3:: References
Required only for Net 30 terms
Bank*
Account #*
Tel*
Trade Reference 1 Name*
Trade Reference 1 Phone*
Trade Reference 1 Fax*
Trade Reference 2 Name*
Trade Reference 2 Phone*
Trade Reference 2 Fax*
Trade Reference 3 Name*
Trade Reference 3 Phone*
Trade Reference 3 Fax*
 
In lieu of a handwritten signature, please enter your name and check the box below before submitting your form.
 
Your Name*
* I authorize the trade and bank reference(s) listed above to release financial or credit information to Interfold, Inc.
Please click on the "Process" button above to start processing the form.