Toyota Material Handling Ohio Cash Customer Set-Up
 
 
COMPANY INFORMATION
 
Bill To:*
 
 
Street:*
 
 
City:*
 
 
State:*
 
 
Zip Code:*
 
 
Phone Number:*
 
 
 
Ship To:
 
 
Street:
 
 
City:
 
 
State:
 
 
Zip Code:
 
 
Phone Number:
 
 
 
Federal ID #:*
 
 
Tax-Exempt:*
 
Yes
No
 
If your company is tax-exempt, a certificate(s) must be returned with this information. If a complete tax exemption certificate is not received, Toyota Material Handling Ohio MUST charge sales tax on your invoices.
 
File Upload (Tax-Exempts, Credit sheets, Etc.)
 
 
 
 
Credit Card Authorization
 
 
BUSINESS INFORMATION (Select all that apply)
 
Business Entity
 
 
Business Information
 
 
Business Information
 
 
Business Entity
 
 
Business Information
 
 
Business Information
 
 
Parent Company Name (If applicable)
 
 
DUNS Number
 
 
Years in Business
 
 
 
 
 
 
Credit Card Charge
 
One Time Charge
Recurring Charge
 
 
Please complete the information below: 
Name:
 
 
I, (authorized AP Personnel) authorize Toyota Material Handling Ohio to process a recurring/one time charge for 
$ Charge:
 
 
on the day service is rendered. 
 
 
*Please note - all payments made by credit card that are over $5,000.00 are subject to a 3% processing fee. 
 
This payment is for  
Goods/Services:
 
 
(Description of goods/services) 
 
 
Billing Address
 
Address:*
 
 
City:*
 
 
State:*
 
 
Zip:*
 
 
Email:*
 
 
Phone Number:*
 
 
Account Type:
 
 
Cardholder Name:*
 
 
 
Account Number:*
 
 
Expiration Date:*
 
 
CVV2 (3 digit number on back of Visa/MC/Discover):*
 
 
Signature:*
 
 
 
Date:*
 
 
 
I authorize the above named business to charge the credit card indicated on this authorization form according to the terms outlined above. This payment authorization is for the amount indicated for the amount above only. I certify that I am an authorized user of this card and that I will not dispute the payment with my credit card company so long as the transaction corresponds to the terms indicated above. I understand that this authorization does not grant permission to charge my card for any additional goods/services.