Account Application

(Necessary for Account setup, even if no credit is required)

Bill To (Firm Name)

DBA (If any)

Communication Email (For confirmation link)

Street Address 1

Street Address 2

City

State

Zip

Phone No.

Fax#

Ship To

Street Address 1

Street Address 2

City

State

Zip

Federal Tax ID#

Years In Business

Corporation

Partnership

Sole Proprietorship

Principal Owner

Accounts Payable Contact

Accounts Payable Tel#

Accounts Payable Email

All Invoices & Statements are emailed. Check box if hard copies are needed.

Email Address for Invoices, C/M, STMTS, Cons. & Payment Confirmations

Email Address for Order & Tracking Confirmations

We Use UPS for Shipments under 300Lbs

Your Ups Account#, If Any

We use explorer trucking or specify your preferred carrier for shipments over 300Lbs

Special tradeShipping Instructions

Please Answer The Following questions so we may better serve you:

How did you hear about us?

Do you intend to carry stock or sampels?

Do you have a store front?

Do you currently purchase rugs from other vendors? (If yes, please specify)

Specify Your Payment Choice For Purchases:

Credit Application (Fill out Page 3)

Credit Card (Fill out Page 4) 3% Processing Fee may apply

Ach Payment (Fill out Page 5)