Owner/principal first name
*
Owner/principal last name
*
Owner mobile phone
*
Owner email
*
Owner/principal title
*
Legal business name
*
DBA (if applicable)
Entity type
*
Business address
Street Address
Country
Enter your country
State
City
Postal Code
EIN (optional)
Years in business
Billing email (for invoices and statements)
*
Accounts payable contact name
*
Accounts payable contact phone
Accounts payable contact email
*
Home store
*
Requested credit limit
*
$
Estimated monthly purchases
$
Trade reference 1: company name
Trade reference 1: phone
Trade reference 1: email
Trade reference 2: company name
Trade reference 2: phone
Trade reference 2: email
Trade reference 3: company name
Trade reference 3: phone
Trade reference 3: email
Bank name (name only; do not enter account numbers)
Is your business tax-exempt?
*
Tax-exempt certificate (upload if tax-exempt)
PDF, JPEG, JPG or PNG
Authorized buyers (people allowed to buy on this account)
Do your purchases require a PO number?
*
How did you hear about us?
Account text notifications (optional)
I agree to receive account notifications (invoices, statements, payment reminders) by text from Spectra Pro Supply at the mobile number provided. Message frequency varies. Msg & data rates may apply. Reply STOP to opt out, HELP for help.
Certification and authorization (required)
*
I certify the information is accurate and authorize Spectra Pro Supply to verify it and check references.
Submit
