New Client Form – Plan First Technologies, Inc

Company Details

Business Name: *

*That you would accept payments or pay bills as.

Type of Business: *

In Business Since: *

Business Primary Phone Number: *

Business Primary Address: *

Address Line 1

Address Line 2

City

State

Zip Code

Legal Form Under Which Business Operates: *

Corporation
Partnership
Proprietorship

Tax I.D. Number *

Tax Exempt: *

Yes
No

Tax Exempt Form Upload: *

Click or drag a file to this area to upload.

Is the business a Division or Subsidiary: *

Yes
No

Name of Parent Company: *

Parent Company in Business Since: *

Business & Technical

Business Owner Name: *

First

Last

Business Owner Title: *

Business Owner Email: *

Is the owner the technical contact: *

Yes, contact them with technical questions.
No, there is an additional contact that handles technical questions.

Question Types: What Operating System does your server run? Do you have a Firewall, how is it configured? Etc.

Technical Contact: *

First

Last

Technical Contact Title: *

Technical Contact Email: *

Day-to-day Business Transactions

Business Transactions Contact: *

First

Last

This contact is approved to make billable decisions on behalf of the business.

Business Transactions Contact Title: *

The address for this client is the same as the primary contact

Yes
No

Business Transactions Contact Address: *

Address Line 1

Address Line 2

City

State

Zip Code

Business Transactions Preferred Contact Method: *

Email
Phone

Business Transactions Contact Phone: *

Business Transactions Contact Email: *

Accounts Payable

Accounts Payable Contact: *

First

Last

This contact is approved to make financial and clerical support decisions on behalf of the business.

Accounts Payable Contact Title: *

The address for this client is the same as the primary contact

Yes
No

Accounts Payable Contact Address: *

Address Line 1

Address Line 2

City

State

Zip Code

Accounts Payable Preferred Contact Method: *

Email
Phone

Accounts Payable Contact Phone: *

Accounts Payable Contact Email: *