Green Customer Intake Form Business InformationLegal Business Name(Required)D/B/AKey Decision Makers(Required)The owner or a person authorized to act on behalf of the business should be included in this list. NameTitleEmailPhone Add RemoveStore Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Account SetupUpload Signed W9Max. file size: 50 MB.Upload Sales & Use Tax FormMax. file size: 50 MB.How should we collect payment?To help your business grow and streamline operations, we are recommending all customers use EFT. M.R. Williams, Inc. is pleased to offer you 30 day terms in place of cash on delivery. Select Payment OptionEFTCash / CheckEFT PaymentsIf you are currently setup as a cash account, please disregard this section. Bank NameAccount Number(Required)Rounting Number(Required)EFT Authorization(Required)As the primary business owner or an authorized signatory for the business listed on this form, I authorize M.R. Williams, Inc. to collect payment via Electronic Funds Transfer.Account Verification(Required)Upload an image of a voided check for the above listed account that will be used for EFT payments. Your bank will be drafted 7 days from invoice date.Max. file size: 50 MB.
