New Account Information Form – Encore What is the legal name of your company, exactly as it will appear on all agreements and invoices?* Suite Number* Who is the point of contact/signatory for all agreements?Contact 1: Name* First Last Email* PhoneContact 2: Name First Last Email PhoneWho is the point of contact for billing?Contact 1: Name* First Last Email* PhoneContact 2: Name First Last Email PhoneWho is the point of contact for communications?Contact 1: Name* First Last Email* PhoneContact 2: Name First Last Email PhoneWho is the point of contact for IT?Contact 1: Name* First Last Email* PhoneContact 2: Name First Last Email PhoneWhat is your permanent mailing address?Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Δ