Customer Information Form (Required) New Updated Tax ID(Required) W-9(Required)Accepted file types: pdf, Max. file size: 2 MB.DUNS#(Required) Date Business Started MM slash DD slash YYYY Tax Exempt(Required) Yes No If yes, send a copy of tax exempt or resale certificate.Tax Exempt or Resale Certificate(Required)Accepted file types: pdf, Max. file size: 2 MB.Company Name(Required) Physical Address(Required) Street Address City State / Province / Region ZIP / Postal Code Main Office Phone(Required)Invoice Remittance Email(Required) Do you have an Online Billing Portal?(Required)YesNoOnline Billing Portal(Required) A/R Contact Name(Required) A/R Contact Phone(Required)Payment Inquiry Email(Required) Remittance Address(Required) Street Address City State / Province / Region ZIP / Postal Code Who at Allied Fire Protection requested you update this form?This form will not be process without this information.Name(Required) Title(Required) Email(Required) Phone #(Required)Signature(Required)Print Name(Required) Title(Required) Date(Required) MM slash DD slash YYYY
