New Client Form fill in and print

559-485-9000 Fax 559-485-9001

New Client Setup

Company:

Remit to Address:

City:    State:   Zip:

Phone Number:         FAX Number:

Billing Rep: Email:

IRS ID or SS Number:

Payment on invoices are thirty (30) days from receipt. One and one half (1.5) percent will be added to invoices thirty days past due.
Please confirm our agreement by signing this printed form and fax the signed copy to: 559-485-9003

I have read and understand the terms listed above. I agree to these terms.
Authorized Signature:__________________________
                           Date:______________

                 Print name:__________________________ Title:______________


            FAX this printed page to 559-485-9003

Company:
Remit to Address:
City:	State: Zip:
Phone Number:	FAX Number:

Billing Rep:	Email:
IRS ID or SS Number:
	Payment on invoices are thirty (30) days from receipt. One and one half (1.5) percent will be added to invoices thirty days past due. Please confirm our agreement by signing this printed form and fax the signed copy to: 559-485-9003

	I have read and understand the terms listed above. I agree to these terms. Authorized Signature:__________________________ Date:______________ Print name:__________________________ Title:______________
	FAX this printed page to 559-485-9003