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Customer Application

Inmark Customer Application

This form is used to establish your account with Inmark. All information must be completed.

Please fax us a copy of your sales tax exemption certificate or we will have to charge sales tax on your orders. You can send it to the following fax number 1-888-123-1234. Please include your submission number and company name to help us locate your information.

Required Fields

Company Information

Company Name
Website Address
Type of Business *

Primary Contact

First Name
Last Name
Email Address

Phone Number
Fax Number
Mobile Number

Alternate Contact

Alternate First Name
Alternate Last Name
Alternate Phone Number
Alternate Fax Number

Billing Information

Name/Company *

Address 1
Address 2
City
State
Zip/Postal Code

Require P.O.

Tax Exempt

Tax ID#

Same as Billing Address

Shipping Information

Address 1 *
Address 2

City *
State *
Zip/Postal Code *

Preferred Warehouse

Preferred Shipping Carrier *

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