US Boot New Account Application | American Sole, LLC

US Boot

New Account and Credit Application

Brand Information

Brand to Set Up

Payment Terms

Brand Outlet Type

Sales Representative

Customer Service Representative

Sold-to Legal Company Name and Address

Corporate Legal Name

Operating As (DBA)

Address Line 1

Address Line 2

City

State / US Territory

Postal Code

Company Phone

Fax

Buyer Contact

Buyer / Primary Contact Name

Buyer Phone

Buyer Fax

Buyer Email

Website Address

B2B Contact

B2B Contact Email

Mail Invoices To

Check if same as Sold-to

Bill-to Name

Address 1

Address 2

City

State / US Territory

Postal Code

Ship Orders To

Check if same as Bill-to

Ship-to Name

Address 1

Address 2

City

State / US Territory

Postal Code

Account Setup Questionnaire

Multiple Ship-to Locations

Will accept backorders?

Tax Exempt

Invoice Preference

Intends to advertise or sell on website?

Vendor Portal URL

Routing Instructions

EDI Enabled

EDI Contact Name

EDI Contact Email

Other Needs / Special Instructions

Account Information

Legal Company Name

City/State

Opening Brand

Credit Application

Date Business Began

Business Structure

Federal Tax ID No.

DUNS Number

Opening Pairs / Dollars

Annual Pairs / Dollars

Accounts Payable Contact

A/P Name

A/P Phone

A/P Email

A/P Fax

Bank and Credit References

Bank Name

Contact Name

City

State / US Territory

Postal Code

Bank Phone

Bank Fax

Bank Email Contact

Trade References

Trade Reference 1

City

State / US Territory

Phone

Fax

Email Contact

Trade Reference 2

Trade Reference 3

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US Boot

New Account and Credit Application

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