1. Login Information:

2. Company Information:

Are any security agreements and/or security interests currently held against your company?

Purchasing Contact Information:
Ship To:
Bill To:

3. Company Ownership Information:

4. Trade Reference:

Please provide (2) References:

5. Delivery Information:

Can your location accomodate a 48' trailer?

Does your location have a loading dock?

Please list any other pertinent delivery information that may assist the driver with your delivery

6. Upload Credentials:

Please upload your tax exemption and business license information below. Files must be in the PDF file format.

Upload Tax Exemption:

Upload Business License:


The above information is for the purpose of obtaining credit and is warranted to be true. I/We hereby authorize GMH DISTRIBUTION, LLC , its assigns and successors as their interest may appear to investigate the information listed pertaining to my/our credit and financial responsibility.

The signature of the applicant attests financial responsibility, ability and willingness to pay our invoices with the stated terms for the customer. All invoices are due per the terms stated on the invoices. Any invoices not paid accordingly will be accessed a finance charge at the GMH DISTRIBUTION, LLC prevailing rate. In the event of default in payment the applicant agrees to be responsible for all costs of collection, including reasonable attorney's fees.

Nonpayment or continued slow payment of product invoices or finance charges will be cause for cancellation of credit privileges. Termination of credit line will not effect in any way the obligation of customer to pay all accrued amounts due.