Accounts Payable

The GSD Technologies team is ready to work with you. Before we get started, we have a few items to take care of.

Fill out the form below so we can add your information to our client database.

Company Name *

Phone *

Billing Address *

Shipping Address (If different from billing)

Accounts Payable Name *

First

Last

Accounts Payable Phone *

Accounts Payable Email *

Tax Exempt *

If yes, please attached a copy of the Tax Exemption Certificate

Click or drag a file to this area to upload.

BANK TRANSFER AUTHORIZATION FORM

I authorize GSD Technologies to electronically debit my bank account according to the terms outlined below. I acknowledge that electronic debits against my account must comply with United States law. *

Yes, I authorize

Terms of Billing (Monthly)

Starting on this Date *

Day of the Month *

Through this Date *

For this Amount in USD *

Customer Bank Account Information

Bank Routing Number *

Bank Account Number *

Account Type *

Checking
Savings

Is this a Consumer or Business account? *

Consumer
Business

Payment Authorization

This payment authorization is to remain in effect until I, [customer name from below] notify GSD Technologies of its cancellation by giving written notice in enough time for the business and receiving financial institution to have a reasonable opportunity to act on it. *

Yes, I authorize

Customer Printed Name *

Customer Signature *

I understand that typing my name on this field constitutes a legal signature confirming that I warrant the truthfulness of the information provided in this application

Date *

Phone