Vibe Restaurant Group Application for House Account
Customer Name
(If you represent an organization, please use the organization's name.
Your answer
Customer is (please indicate one):
Customer Address
Your answer
Customer Telephone
(Please included area code)
Your answer
Primary Contact Person
Your answer
Primary Contact Email
Your answer
Is customer exempt from sales tax?
If yes, please provide a copy of the organization's current tax exempt certificate.
Your answer
I hereby certify that I am a representative of the customer described above and that I am authorized to establish this account and bind the organization to the terms thereof. I also certify that I have been provided a copy of the Customer Information Sheet and understand the terms and conditions therin.
Digital Signature
Your answer
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