Get Onlinemedlinecom Form

Completing the Onlinemedlinecom Form is essential for establishing your account with Medline Industries Holdings, L.P. This guide will provide you with clear, step-by-step instructions to ensure a smooth submission process for your customer credit application and agreement.

Follow the steps to fill out the Onlinemedlinecom Form online.

1. Press the ‘Get Form’ button to access the credit application form and open it in your preferred document editor.
2. Begin with the ownership information section. Identify the parent company or principal owner(s). If there are multiple owners, provide a complete list with names, addresses, and ownership percentages.
3. Fill in the details of the parent company, including the GLN master number and the address of the controlling entity.
4. Complete the name and ownership percentage for each principal owner or stockholder. Additionally, provide the annual revenues and requested credit limit.
5. If there is a sole proprietor or majority shareholder, include their home address, city, state, phone number, title, zip code, and last four digits of their social security number.
6. In the 'Sold To' section, enter the registered corporate name or DBA, including the address, city, state, and zip code.
7. For the billing information, input the company's name, address, city, and accounts payable phone and fax numbers. Specify the accounts payable contact person's name and email address.
8. Complete the shipping information section if there is a designated shipping location. Provide the business name, GLN master number, address, and phone/fax numbers.
9. Indicate the portion of revenue dependent on government funding, type of business, number of employees, number of beds, and whether you are part of a buying group.
10. Provide information about the management company or third-party payer if applicable. Include company names, addresses, and contact information.
11. If you qualify for tax exemption, include the tax exemption or resale number, and provide the federal ID number if applicable.
12. For prescription drug purchases, ensure you provide the required licenses and documentation. Failure to do so may result in the exclusion of RX items.
13. Review the terms outlined for invoices, defects, and legal jurisdiction as you complete the agreement.
14. Finalize the application by signing it and dating it at the designated section. Ensure the bank release authorization form is attached.
15. Once you have filled out the form completely, save your changes, and you can now print, download, or share the completed document.

Complete your Onlinemedlinecom Form online today to expedite your account setup.