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Advanced Door Concepts
222 Commercial Place Sebring, FL 33876
Phone: 863-655-DOOR (3667)
Fax: 863-655-3663

NEW ACCOUNT FORM

All orders will be shipped on a cash basis unless other arrangements have been made at the time of order placement.
The information requested in #1 through #4 must be completed in full prior to shipment of order.


Section 1 - ACCOUNT INFORMATION
(*All fields are mandatory unless noted otherwise)
Company Name:
Mailing Address:
Phone:
City:
State:
Zip:
 
Delivery Address:
Phone:
City:
State:
Zip:
 
Fax:
Email:
 
Section 2 - BUSINESS INFORMATION
 
Type of Business:
Date Incorporated or started:
Federal ID#
 
Corporation
(Must list: President,Secretary,Treasurer & home address, phone, DL# for each)
Partnership
(Must list: All Partners & home address, phone, DL# for each)
Proprietorship/Individual
(Must list: Company owner & home address, phone, DL# for each)
 
Primary (President/Owner)
Name:
Title:
DL#:
Home Address:
City:
State:
Zip:
Phone:
 
Secondary (if applicable)
Name:
Title:
DL#:
Home Address:
City:
State:
Zip:
Phone:
 
Tertiary (if applicable)
Name:
Title:
DL#:
Home Address:
City:
State:
Zip:
Phone:
 
Registered Agent:
Registered Agent Phone:
 
Section 3 - BANK INFORMATION
 
Checking A/C#:
Bank Name:
Address:
City:
State:
Zip:
Phone:
 
Section 4 - TAX STATUS
 
Pays Tax
Resale (Sign Certificate Below)
Purchaser:
Address:


If for resale, please complete the following, otherwise leave blank and proceed to submit form. Electronic reciept of your resale certificate details is only a temporary measure provided in good faith to allow us to process your order. We need you to fax or mail a hard copy of your resale certificate to us ASAP.

Florida Department of Revenue, Sales Tax Division
Blanket Certificate of Resale

This is to certify that all material, merchandise, or goods purchased by the undersigned from Advanced Door Concepts, Inc., after 02/17/2020 is purchased for the following purpose:
Resale as tangible property
To be incorporated as a material or part of other tangible personal property to be
      produced for sale by manufacturing, assembling, processing or refining.
To be exported for sale, use, or consumption outside the continental limits of the United States.
Other
 
Certificate #:
Electronic Signature:
 

Since all orders are custom in nature, once an order is placed and signed off on it cannot be changed or cancelled. The owner will be held liable for payment.


Advanced Door Concepts, Inc.
222 Commercial Place
Sebring, Florida 33876
Phone: 863-655-3667 (Door)    Fax: 863-655-3663
Email: info@advdoor.com