New Customer Setup

Customer credit application

Complete the application below so VIEWDIA can review your account, set up billing, and prepare your team to ship with approved credit terms.

Before you submit

Have your billing, bank, and reference information ready.

This test page mirrors the current VIEWDIA setup form structure. For production, connect this page to Gravity Forms with secure storage and restricted access.

Company InformationSales RepBusiness Name *DBA / Trade NamesBilling Address *EIN / TIN *DUNSPhone *Date business startedLegal business structure *Owner / officer if less than 2 years in businessTitle

Financial InformationEstimated monthly credit requestedAnnual revenueHas the company previously filed bankruptcy?Send monthly statements?Would you like paper copies of invoices?

Accounts PayableA/P Name *A/P Phone *A/P Email *

Company ContactsNameLocation / departmentTitlePhoneEmailAdd another contact?

Bank InformationBank Name *Account number *Routing number *Bank POC NamePOC branch / locationPhoneAddress

Industry ReferencesCompany nameContact nameAddressPhoneEmailCompany nameContact nameAddressPhoneEmailCompany nameContact nameAddressPhoneEmail

Consent

Credit authorization and terms acknowledgement

Applicant authorizes VIEWDIA, LLC to contact banks, lenders, creditors, and references listed in this application; verify credit and financial information; and evaluate open account credit. Applicant confirms the information provided is true, correct, and complete.

Upon approved credit, invoices are payable within 30 days from invoice date unless a separate written agreement signed by VIEWDIA applies.

Consent *Date *Name *Electronic signature *

Personal Guarantee

If your business is less than 2 years old, or if your VIEWDIA representative indicates a guarantee is required, complete this section.

Personal guarantee needed *Guarantor nameSocial security numberPhoneEmailTitleAddress

This is a test layout. Do not collect live bank or SSN details until the secure form workflow is connected.