VIB-New Customer Form

Today's Date: 4/19/2025 9:45:56 AM

First Name: Invalid first name. Please enter a valid first name with letters, spaces, apostrophes, and hyphens only.

Last Name: Invalid first name. Please enter a valid last name with letters, spaces, apostrophes, and hyphens only.

Phone Number:

Email: (Email to be used for invoice and receipts) Email ID is required.

Same As Company Address?

Billing Address: Invalid address. Please enter a valid billing address with letters, numbers, spaces, commas, periods, apostrophes, and hyphens only.

Billing City: Invalid city name. Please enter a valid billing city name with letters, spaces, apostrophes, and hyphens only.

State: Invalid state name. Please enter a valid state name with letters, spaces, apostrophes, and hyphens only.

Zip: Invalid ZIP code. Please enter a valid ZIP code (e.g., 12345 or 12345-6789).

Country: Invalid country name. Please enter a valid country name with letters, spaces, apostrophes, and hyphens only.

Sales tax exemption Status:
Yes No

If yes,you will need to submit a copy your sales tax exemption certificate in order to take effect.

Required Documents

VIB Credit Form (Business Customers Only): Download Here Sales Tax Exemption:

Type the code from the image

Please fill out this form to have your business set up as a new customer. New customers are required to make their first payment by credit card. Thereafter, you may contact customer service to change your account to 30 day net.