PLEASE fill in, print and then fax your Bank References to 1-877-621-5469/440-240-0214

Financial Information
Attention Libraries, Schools, and Universities: You may bypass the Dun & Bradstreet Number field if you are unable to provide the number.

Dun & Bradstreet's #
Federal Tax # or Resale #: *
Are you tax-exempt?	Yes No
If you are tax-exempt, please fax your Tax Exemption Certificate to 1-877-621-5469/440-240-0214.

Bank Reference Information
Attention Libraries, Schools, and Universities: You may bypass the Bank Reference Information section if you are unable to provide this information.

* Required Entries

Bank Name *
Bank Account Number *
Contact Name *
Address Line 1 *
Address Line 2
Address Line 3
Phone:*
Fax:
City *
*State/Province