New Account Register

If you already Have an account with PBS and are only looking to sign up for online access to view your invoices / Purchase your parts online / pay balance with CC or ACH

Click Here to Register for online access to your Existing account.

Company Info:

What Type of Account are you Looking For? *

Primary Store you Will Purchase from?

Company Name

Billing Address

City / State / Zip

Office / AP Contact Name

Office / AP Phone

Office / AP Email

AP Options. Select box if Yes\u003cbr\u003e

Would you like Statements Emailed?

Would you like Invoices Emailed?

Are Purchased Orders Required?

Will purchases be tax Exempt?*

If tax Exempt, Please upload valid tax exemption form

Purchasing Info:

(Leave blank if Same as above)

Purchasing Contact

Purchasing Email

Purchasing Phone

Would you like to Receive our Monthly flyer via email?

Shipping Info:

(Leave Blank if Same as Billing)

Shipping Address

Shipping City / State / Zip

Please List any Additional Ship To Location Addresses

For Credit Applications only:

Requested Credit Limit (In Dollars)

Business Establishment Date

Has the Company or any principal owner filed bankruptcy in the last 7 years?

Federal Tax ID

Parent Company (If Applicable)

Principal Stock Holders

Address / City / State

Phone / Email

Credit Reference # 1 - Company / Contact / Phone / Email

Credit Reference # 2 - Company / Contact / Phone / Email

Credit Reference # 3 - Company / Contact / Phone / Email

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