Customer Profile Sheet
National Accounts

" " indicates required fields

Axis Point of Contact (Required)

Customer Profile Information

Name (Optional)

Company (Required)

DBA (Optional)

Invoicing Method (Required)

Billing Profile Information

Corporate: Street Address (Required)

Corporate: City (Required)

Corporate: State (Required)

Corporate: Zip (Required)

Corporate: Country (Required)

Federal Tax ID (Required)

Site: Street Address (Required)

Site: City (Required)

Site: State (Required)

Site: Zip (Required)

Site: Country (Required)

Federal Tax ID (Required)

Site AP Name (Required)

AP Phone (Required)

AP Email (Required)

Invoicing Preferences

Invoice Submission Type (Required)

Invoicing Email (Required)

Please select Portal Name

Other Portal Name

Do you want one work order per invoice or multiple invoices per work order?

Tax Information

Tax Exempt Resale? (Required)

Tax Certificate (Must be submitted with application for each state doing business.) (Required)

Accepted file types: jpg, gif, png, pdf, Max. file size: 10 MB.

Insurance Requirements

Does your company require a Certificate of Insurance? (Required)

Please select preferred type (Required)

Please attach COI Example if available. (Optional)

Accepted file types: jpg, gif, png, pdf, Max. file size: 10 MB.

Key Contact: Billing & Administrative

Accounts Payable Point of Contact (Required)

Phone (Required)

Email (Required)

Remittance Point of Contact (Optional)

Phone (Optional)

Email (Optional)

Can an invoice be submitted without a PO#? (Required)

Please provide specific invoicing instructions. (Required)

Phone

This field is for validation purposes and should be left unchanged.

Customer Profile SheetNational Accounts