NEW ACCOUNT APPLICATION FORM

Please fill out this form in its entirety

"*" indicates required fields

Step 1 of 4

Ship To Address (if different than bill to):

Ship to Address

Company Name Address Line 2 City State / Province / Region ZIP / Postal Code Country

Are there additional ship to addresses?*

Yes (please list below)

Secondary Ship to Address*

Company Name Address Line 2 City State / Province / Region ZIP / Postal Code Country

Purchase Order Contact Information:

P.O. Contact Name*

P.O. Contact Title*

P.O. Contact Email*

P.O. Contact Phone*

P.O. Contact Fax

Shipping Information

Email address to receive order tracking information*

Contact Name*

Contact Title*

Select Your Preferred Shipping Method*

PRE PAY AND ADD TO INVOICE UNDER DOWN INC. SHIPPING ACCOUNT - Our shipping account is contracted for our product to give you the best pricing available

YOUR UPS ACCOUNT

YOUR FEDEX ACCOUNT

Account Number*

Special Shipping Instructions:

Provide a Copy of Your Sales Tax Certificate

Certificate submission options*

Upload a Copy

I will email a copy to: customerservice@downinc.com

I will fax a copy to: 616-452-1255

Upload Sales Tax Certificate*

Max. file size: 50 MB.

Payment Method

Choose Payment Method*

Credit Card

Net 30 Application

CONGRATS!

You have chosen to set up your new account as Credit Card payment. Payment method is not required to set up an account, but will be required when placing yourfirst order.

3 easy ways to provide your confidential credit card information:

SECURE ONLINE ORDERING: EASY... Submit credit card information upon check-out. Done.
VIA EMAIL/FAX: A FEW MORE STEPS, but still simple. Before ordering remember to:
- Download Credit Card Authorization form
- Save
- Fill-out
- Email back to: customerservice@downinc.com
VIA PHONE: Yes, we still talk to customers daily! If you love chatting with a "real" person just call & tell us your CC#.

Net 30 Day Terms Application

Company Name*

Date Applied*

Contact for Additional Information*

Contact's Phone Number*

Contact's Email*

References

Please provide 3 references that you have done business with in the last five years.

Reference 1

Company Name*

Email Address*

Account Number*

Phone Number*

Fax Number*

Year Account Opened*

Reference 2

Company Name*

Email Address*

Account Number*

Phone Number*

Fax Number*

Year Account Opened*

Reference 3

Company Name*

Email Address*

Account Number*

Phone Number*

Fax Number*

Year Account Opened*

Legal

We certify that the above information is true and correct to the best of our information, knowledge and belief. We agree to pay all charges according to the terms and conditions as stated by DOWN inc. ("Creditor"). If we fail to do so, then we agree to pay any late charges, reasonable collection costs and attorney fees if collection procedures are instituted. Should credit availability be granted by Creditor, all decisions with respect to the extension or continuation of credit shall be at sole discretion of Creditor. Creditor may terminate any credit availability within its sole discretion.

We authorize you to conduct an investigation of our credit worthiness, including but not limited to securing commercial credit reports, consumer credit reports, trade references, lender references, lease references.

We hereby authorize release of credit information to DOWN inc.

Print Name*

Authorized Signature*

*E-Signature accepted as your full authorization.

Title / Position*

Date*

NEW ACCOUNT APPLICATION FORM

About Your Business

Billing Information

Person to contact for payment of invoices:

Ship To Address (if different than bill to):

Purchase Order Contact Information:

Shipping Information

Provide a Copy of Your Sales Tax Certificate

Payment Method

Net 30 Day Terms Application

References

Reference 1

Reference 2

Reference 3

Legal