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Government Account Application - Set text to
medium before
printing: Menu: View/Text Size/Medium ______________________________ ,
____________________________ , ___________________________ Billing Address: ____________________________ City __________________ State ________ Zip _________ E-mail: ____________________________ Retail Tax Number (Vendors License): N/A ___________________ Phone: ( _______ ) ____________________ Fax: ( ______ ) ___________________ Year Established_______ Federal Non Profit Tax ID # ______________________ Website _____________________________________ Government Type US ______State _______
County___________ City ________________Other_______________ Name __________________________ Title ___________ Phone ( ______ ) ______________ Address ____________________________ City ______________________ State ______ Zip __________ Name __________________________ Title ____________ Phone ( ______ ) ______________ Address ____________________________ City ______________________ State ______ Zip __________ Bank Name ___________________________ Acct No. _________________ Phone ( ______ ) _______________ __________________________________________________________________________________________ Phone: ( _______ )_____________________ Fax: ( ______ )___________________ ___________________________________________________________________________________________ Phone: ( _______ )_____________________ Fax: ( ______ )___________________ GOVERNMENT GUARANTEE: This entity will be responsible if our account becomes delinquent and will pay
finance charge _______________________________________________________________________________________ How fast can invoices be paid ____30 days ____ 10 Days
____ Days
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