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Customer Information Form

Best contact during set up.

Company Information

Please complete the following company information. This would reflect the information on your IRS W-9 form (or similar government documentation).

Do you use a separate "Bill to" or "Accounts Payable" company address?

If the address is the same as your Company Address above, select "No".
If you want your invoices mailed to a different address, select "Yes".
This is the email we will use to electronically send you your invoices.

Do you have a "Parent Company"?

How would you like to pay?

Thank you for completing our Customer Information Form.

Please read and sign below, then click submit.
We look forward to working with you!

ClassicPlus is a Matrix Imaging Solutions Company