NET30 Direct Credit Terms — Lift Off Distribution

How would you like to complete your forms?

Option 1 — Download blank PDFs

Print, handwrite, and email completed forms with a voided check.

Download Credit Application Download EFT Form

Option 2 — Fill out online & download

Complete the forms below, then generate a printable packet you can save as a PDF and email.

Online NET30 packet

Credit Application

Business / Legal Name

DBA (if different)

Billing Address

City

State

Zip

Business Phone

Accounts Payable Email

Federal Tax ID

Business Type

Years in Business

Owner / Officer

Name

Title

Phone

Trade References

Trade Reference 1 (Name, Phone, Email)

Trade Reference 2

Trade Reference 3

EFT Authorization

Bank Name

Bank Address

Routing Number

Account Number

Account Type

Authorized Signer Name

Title

Date

By signing, you authorize Lift Off Distribution to initiate electronic funds transfers (EFT) for payment of invoices to the bank account listed above, and certify that all information provided is true and correct.

After clicking “Generate Completed Packet”, your answers will open in a print-friendly layout. Choose “Save as PDF” in your browser’s print dialog, then email the saved file with a voided check to krosen@liftoffdc.com.

Need help?

Email dthomas@liftoffdc.com or call/text 540-395-7455 (24/7) and we’ll send the forms or a pre-filled packet to you directly.