Vendor Setup - tooshlights

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, Max. file size: 20 MB.

UPLOAD A VOIDED CHECK OR BANK LETTER

Accepted file types: jpg, jpeg, gif, pdf, png, rtf, txt, Max. file size: 20 MB.

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

Name

This field is for validation purposes and should be left unchanged.