COD Account Request Form - PECO Sales & Rental

This form should be completed for customers that are frequent parts purchasers, but do not want a charge account. Payment is due upon receipt. Payment methods include cash, credit card, or check.

Business Name*
Business Contact Name*
Business Address*
Street Address City State ZIP Code
County*
Email
Phone*
Primary Industry*
PO Required?*
- YES
- NO
Tax Exempt?*
- YES
- NO
Sales Tax Exemption Certificate Upload
Max. file size: 50 MB.
Power Equipment Company Representative (Sales or Parts Rep)
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