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We would like to learn more about your customers whose invoices you would want to accelerate for faster payment. Please enter details below about the customer that you would like Raistone to evaluate.

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Customer Enrollment Form

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Customer Information

We would like to learn more about your customers whose invoices you would want to accelerate for faster payment. Please enter details below about each customer that you would like Raistone to evaluate.

Your customer's legal business name*

Your customer's address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

What invoice platform does your customer use?*

What is the name of the platform?:*

Any other invoice platform that your customer utilizes?

Yes

Please list those platforms below:

Do you utilize any additional AP Platforms for this customer?

Yes

What payment terms do you typically provide this customer?

How long have you been working with this customer?

In Years. Please enter 0 if it has been less than a year.

What is your average invoice size to this customer?

What are your approximate annual sales with this customer?

What is your current accounts receivable balance with this customer?

Would you like to automatically accelerate payment of all of your invoices to this customer?*

Raistone has an autoXcel feature which enables you to automatically accelerate all invoices from a specific customer. Otherwise, you have the option to manually select which eligible invoices you would like to accelerate for payment.

Yes

Master Service or Vendor Agreement

Drop files here or

Max. file size: 100 MB.

Sample Invoice Copy

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Max. file size: 100 MB.

Sample Purchase Order

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Max. file size: 100 MB.

Sample Historical Payment Remittance

Drop files here or

Max. file size: 100 MB.

W-9

Drop files here or

Max. file size: 100 MB.

Would you like to add an additional customer?*

Yes

If you’d like to know more about Raistone Pricing, you can view it here

Please contact us with any questions you might have. Email us at contact@raistone.com.

Additional due diligence information may be requested after submission.

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FIRST NAME

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LAST NAME

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Your Title

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Phone Number

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Legal Business Name

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Primary Business Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

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What are your approximate annual sales?

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OPT-IN

Yes, please send me articles, insights and webinars

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