Vendor Setup

(Vendor to fill in all fields below)

GENERAL INFORMATION
VENDOR NAME (Payable to)
REMIT TO ADDRESS
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
PHYSICAL ADDRESS
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
TELEPHONE
Fax
FEDERAL IDENTIFICATION SALES TAX ID / NUMBER (EIN)
SALES TAX ID / NUMBER (EIN): RESELLER NUMBER
CUSTOMER NUMBER TO VENDOR
*PAYMENT DEFAULT TERMS ARE NET 30 | PAYMENTS ARE MADE ELECTRONICALLY BY ACH*
FOR PAYMENTS

1. UPLOAD A W9
2. UPLOAD A VOIDED CHECK OR BANK LETTER
3. FILL OUT INFORMATION BELOW
4. ALL INVOICES SHOULD BE SENT TO: EDI.Invoices@modus-systems.com

ACH AUTHORIZATION: We authorize Modus Systems, LLC to remit payment as credit entries to our account. In order to revoke this authorization, we will provide written notice to Modus Systems, LLC; 21900 Burbank Blvd #116 Woodland Hills, CA 91367
UPLOAD A W9
Accepted file types: jpg, jpeg, gif, pdf, png, rtf, txt.
UPLOAD A VOIDED CHECK OR BANK LETTER
Accepted file types: jpg, jpeg, gif, pdf, png, rtf, txt.
TYPE OF ACCOUNT
Other
BANK ROUTING NUMBER
BANK ACCOUNT NUMBER
CONTACTS
CEO / OWNER
Name
Phone Number
Email
VP / SENIOR EXEC
Name
Phone Number
Email
SENIOR MANAGER
Name
Phone Number
Email
SALES MANAGER
Name
Phone Number
Email
CONTROLLER
Name
Phone Number
Email
ACCOUNTS RCVBL
Name
Phone Number
Email
CAPTCHA
Phone
This field is for validation purposes and should be left unchanged.

GENERAL INFORMATION