SECTION 1: NEW VENDOR PROFILE FORM

In order for us to process your Vendor Profile Form, your business must be active on the Oregon Business Registry.

BUSINESS NAME: We need the name of your business, not necessarily your name (unless your name is the business name).

DBA: Sometimes businesses have brand names that are different than the primary business name. Only fill out if applicable. (DBA stands for Doing Business As)

CONTACT PHONE: The phone number of the person to contact for sales, promotions, pricing questions or product questions.

EMAIL: The email address of the person to contact for sales, promotions, pricing questions or product questions.

BUSINESS ADDRESS: The street, unit/suite, city, state and ZIP code.

Please provide us with your company website and social media pages, handles, #, @, etc.

BROKER: The name of your broker account representative.

BROKER PHONE: The account representative’s phone number.

BROKER EMAIL: The account representative’s email address.

BROKER BUSINESS: The name of the broker firm.

BROKER ADDRESS: The street, unit/suite, city, state and ZIP code.

ACCOUNTING CONTACT: The name of the individual at your company who we will work with for payments, credits or other accounting issues.

ACCOUNTING PHONE NUMBER: The phone number of your accounting contact.

TAX ID NUMBER: A tax ID number is required.

TYPE OF BUSINESS: We need to know what type of business you are for taxes:

• C-Corp: Is any entity that is taxed separately from its owner.
• S-Corp: Is a Federal Income Tax structure where your profits or losses are passed through the ownership of the company.
• LLC: If you have legally defined and registered your business as a Limited Liability Corporation.
• Individual: If you are the individual owner of the company.

CHECKS OF PAYABLE NAME: The name you want us to use when issuing a check.

CHECKS OF PAYABLE ADDRESS: The address you would like to receive payments.