New Customer Application - Colony Packaging & Machine

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Business Information

Legal Company Name

d/b/a Name (if applicable)

Phone

Fax

Mailing Address

Address Line 1

Address Line 2

City

State

Zip Code

Delivery Address

Address Line 1

Address Line 2

City

State

Zip Code

Layout

State of Incorporation

Business Type

# of Employees

Fed ID #

SIC Code

DUNS Code (if applicable)

Dun & Bradstreet Code

Date Established

Entity Type

Layout

Has this company ever filed for bankruptcy?

Ordering Information

How would you like to purchase with us?

Open Terms (preferred)
Credit Card
Check / Cash in Advance

Is a Purchase Order number required for us to process orders?

Sign me up to order online, view past/open invoices, and purchasing history

Yes
Not at this time

Layout

File Uploads

To establish an account we require your company W9. If you are tax exempt we also need a valid tax exemption form.

File Upload - W9 Form

Click or drag a file to this area to upload.

.pdf files only, 10 MB

Are you tax exempt?

Note - if we do not receive a tax exemption certificate we will charge tax until otherwise updated. If you have mixed tax requirements please select "no" and contact our accounting department directly with your specific situation - thank you!

Business Information

Contact Information

Delivery Information

Ordering Information

Bank Information

Trade References

Trade References

File Uploads