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Account Application & Agreement

Please complete ALL of the required information below. *Denotes Required Fields. This information will be sent via email to Keeton's Controller and any additional information needed to compete the account setup will be obtained via phone or email after this application is received. This process is not instantaneous, so please allow enough time for the application to be received and processed. Thank you.

Account Type:

Open Charge Account - All purchases will be charged to an open account with Keeton's. A monthly statement will be mailed or emailed each month and payment is due by the 10th of the month following purchase. Click Here for a printable Open Charge Account application.

Credit Card or C.O.D. Account - All purchases will be paid for by customer's credit card, or paid C.O.D. at time of delivery. For security reasons, please DO NOT provide your credit card information anywhere on this application. A Keeton's representative will contact you after this application is received. Thank you. Click Here for a printable Credit Card Account application.

	Billing Information:
	Name of Business	*

	Address	*

	Address (continued)

	City	*

	State	*

	Zip Code	*

	County	*

	Billing Contact Name	*

	Phone	*

	Fax

	Email	*


	Delivery Information:
	Name of Business (if different)

	Address

	Address (continued)

	City

	State

	Zip Code

	County

	Delivery Contact Name	*

	Phone	*

	Fax

	Email

Business Information:

	Type of Business		Business Status
*		*

	Sales Tax Rate (of delivery address)		Years Established
*	% If sales tax exempt, please attach a copy of your current certificate.	*

	Monthly Average Purchases		Purchase Order (PO) Required for orders?
$			Yes No

Company Principals: (not required for Credit Card Account)

Name:	Title	Phone

Name:	Title	Phone

Name:	Title	Phone

Trade References: (not required for Credit Card Account)

Name:	Address	Phone

Name:	Address	Phone

Name:	Address	Phone

Bank:	Address	Phone

How did you hear about Keeton's?

Additional Comments:

AUTHORIZATION TO RELEASE INFORMATION AND ACCEPTANCE OF TERMS

By checking the appropriate box below and clicking on Submit Form to Keeton's, I confirm that I have authority from the above company to complete this application for an open account with Keeton's Office & Art Supply. I further authorize the trade references listed on this application to release the information necessary to assist in establishing a line of credit. I understand that other sources of credit information considered necessary may also be used. Please check the appropriate box below for the type of account that you are applying for.

Open Charge Account - I have read and agree to the Terms and Conditions set forth by Keeton's Office & Art Supply.

Credit Card Account - I agree to pay all charges according to the credit card issuer agreement. All approved merchandise returned for credit will be credited back to the original credit card number used. I agree to keep my credit card information current that is on file with Keeton's Office & Art Supply.

Name of Person Submitting Application * Title *

Email webmaster with questions or comments about this website. Copyright © 2001-2012 Keeton's Office Supply Co., Inc.
Corporate Office: 817 Manatee Ave. W Bradenton, FL, 34205, United States
Phone: 1.800.833.4735 Fax: 1.800.833.4786