Independent Funeral Homes of Virginia

NEW ACCOUNT SETUP

Name*
First
Firm Name*
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Fax*
Email*
Authorized Contact Personnel at your firm:*
Business Tax ID Number:*
Type of Business:
- Corporation
- LLC
- Partnership
- Sole Proprietor
Promo Code:
Additional Information or Requests:
Preferred Method of Payment:*
- Direct Wire Transfer ($15 wire fee) - Funds are wired to your bank for Immediate use
- ACH Deposit - Funds deposited for next business day credit. Holidays and weekends will delay funds.