New Client Profile | Louisville, KY | Argentum IT LLC

Contact Us Today! (502) 473-9330

New Client Profile

Please complete this form to allow us to complete your company setup.

Email *

Company Name *
?
Please update company name if incorrect.
Website URL *
?
Please enter your company's website URL.

Legal Name of Entity
?
Please enter your company's legal name, if different from DBA.
Type of Entity *
?
Select the type of entity your business operates as.

Tax Exempt *
Yes
No
?
Is your organization tax exempt?
Tax Exempt Number
?
Please write your your tax exempt number here, if applicable.
W-9 Attachment

Mailing Address *
?
Please enter your MAILING address.
City *
?
Enter the city of your mailing address.
State *
?
Enter the state of your MAILING address
Zip Code *
?
Please enter the zip code of your MAILING address.
Physical Address *
?
Please enter your PHYSICAL address
City *
?
Please enter the city of your PHYSICAL address.
State *
?
Please eneter the state of your PHYSICAL address.
Zip Code *
?
Please enter the zip code of your PHYSICAL address.

Shipping Address *
?
Please enter your SHIPPING address.
City *
?
Please enter the city of your SHIPPING address.
State *
?
Please enter the state of your SHIPPING address.
Zip Code *
?
Please enter the zip code of your SHIPPING address.

Billing Address *
?
Please enter your BILLING address.
City *
State *
?
Please enter the state of your BILLING address.
Zip Code *
?
Please enter the zip code of your BILLING address.

Primary Account Contact First Name *
?
Please enter the person with whom primary contact should be made (the decision-maker.)
Primary Account Contact Last Name *
?
Please enter the primary account contact's last name.
Phone *
?
Please enter the primary phone number for contacting.
Secondary Phone
?
Please enter another phone number.
Primary Contact's Email *
?
Please enter the primary contact's email address.

Billing Contact *
?
Please enter the Billing Contact's Name
Billing Phone *
?
Please enter the billing contact's phone number.
Billing/Invoice Email *
?
Please enter the email of your BILLING department (where invoices should be sent.)