CPI Office Products

Business and Billing Information

*Required Information

Legal Business Name *
Billing Address *
City *
State *
Zip Code *

DBA (if applicable)

Contact Name *
E-Mail Address
Phone Number *
- - Fax Number
- -

Contact Title
Number of Employees
Estimated Monthly Purchases

Buyers Name *
E-mail Address
Phone Number *
- - Fax Number
- -

AP Name *
E-Mail Address
Phone Number *
- - Fax Number
- -

Same as Billing Address Shipping Address (if different from billing: can not be P.O. Box) *
City *
State *
Zip Code *

DUN & Bradstreet Number
Date Business Started
/ /

Type Of Business *

Corporation
Partnership
LLC
PLL

Propiertorship (enter reference SS# Below)
- -

State Tax Exemption Number
Federal Tax ID Number *

Trade References *

A minimum of 3 are required. Please, no other office supply companies, credit card companies, UPS, FedEx, etc., as they will not give us a reference. Please list open accounts only.

Credit Reference 1 Name
Account Number
Fax Number
- - Address

City
State
Zip Code

Credit Reference 2 Name
Account Number
Fax Number
- - Address

City
State
Zip Code

Credit Reference 3 Name
Account Number
Fax Number
- - Address

City
State
Zip Code

I agree that all payments are to be made to CPI Office Products, Inc., Lewisville, TX 75209, PO Box 292130, Lewisville, Denton County, Texas 75029-2130. I understand your payment terms of NET 30 DAYS and agree to abide by them. By making an application for credit I also understand that an investigative process may be initiated whereby information may be obtained though credit information sources in addition to those provided by this document.

TAXES: CPI Office Products, Inc. will accept a valid Exemption Certificate. However, if an Exemption Certificate previously accepted is not recognized by the taxing authority and CPI Office Products, Inc. is required to pay tax, you agree to reimburse CPI Office Products, Inc. Such taxes will be billed to you seperately.

By checking this box you have read and agree to these terms.

Business and Billing Information

Trade References *

My Account

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