4691 Northwest Parkway, Hilliard Ohio 43026 New Account Application   All Fields Are Required Date Business Name Owner / Authorized Agent Name Business Tax ID Number Email Address Business Address What Carriers do you sell Phone ( ) - - Alt Phone ( ) - - Fax ( ) - - Owner / Authorized Agent Signature Date By signing this application, I acknowledge that I’m responsible to pay for all orders requested by phone or in writing by me or any authorized agent on our behalf. Also, I acknowledge, fully understand and received a copy of IOC warranty policy and product description. In an event that an order that we have placed was not paid for and was returned to the sender (IOC) due to our negligence of not preparing the funds or for any other reason that may cause the shipment to be returned to the sender (IOC), in that case I agree that I will be fully responsible for all shipping charges and maybe subject to a restocking fee related to that shipment / order.