New Account – Optima Cotton Wear Inc.

Company Name: *

Company Phone #: *

Company Email: *

Address 1: *

State: *

Postcode/Zipcode: *

Address 2:

Country: *

Company Website / URL

Type Of Entity:

Corporation (if you are using a fictitious business name, please include the ficticious name).
Limited Liability Corp
Limited Partnership
Partnership
Sole Proprietorship

Federal Tax ID (FEIN):

Resale#: *(Required for California Businesses)

Business Start Date:

Owner first name:

Owner last name:

Owner Phone:

Owner Email:

Owner address

State:

Postcode/Zipcode:

Owner Address 2:

Country:

Application: Name: Payable

First name:

Last Name:

Purchasing Phone:

Purchasing Email:

First name:

Last Name:

Accounts Payable Phone:

Accounts Payable Email:

Preferred Shipping Method:

UPS/FedEx Account#:

How did you hear about us?:

Please submit your W-9, Resale certificate, Credit Application:

Click or drag files to this area to upload. You can upload up to 3 files.

Resale certificate *(Required for California Businesses) visit Resale Certificate