New Customer Information

Ready to get started with Sebastian? Please complete the New Customer Information form below. Providing the requested information will help us set up your account and ensure we have the details needed to support your service and billing needs.

A. Company Information

Company Name

Site Address(Required)

Street Address Address Line 2 City State ZIP Code

Site Contact for Service

Company Email(Required)

Telephone

Ext.

Does your company have multiple sites?

Yes

B. Billing Information

Billing Address(Required)

Street Address Address Line 2 City State ZIP Code

Billing Contact

Contact Email

Telephone(Required)

Ext.

Fax

Billing Email

Invoices sent to email

Business Type

Sales Tax Number

Exempt

Do you need a W-9 From Sebastian?

Yes

C. Payment Information

Preferred Payment Type:

E-invoicing

Vendor Specific Payment Instructions?

D. Purchase Agreement

By completing and signing this application I agree to be bound by Sebastian’s standard terms and conditions of sale for all purchases on this account and hereby certify that the business named above is properly licensed in accordance with all municipal, local, state, federal and other laws and regulations applicable to the installation and servicing of products purchased from Audeamus, doing business as Sebastian.

Name

First Last

Title

Signature(Required)

Date

New Customer Information

A. Company Information

B. Billing Information

C. Payment Information

D. Purchase Agreement

SERVICES

COMPANY

SOLUTIONS

LOCATIONS

BE SOCIAL