Whether you are interested in becoming a reseller or you are with a healthcare facility, setting up an account could not be easier.

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Credit Card Purchases: Download and complete the Customer Profile Form and return it with your W9 Form.

(1 & 2 below)

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Terms Account: Download, complete, and return the Credit Application along with the Profile Form and W9.

(1, 2, & 3 below)

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1. Customer Profile Form

2. Blank W-9 Form 

3. Credit Application* 

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Return to saferlock@att.net or by fax at 601-353-0411.

Please use New Account Setup in the Subject Field or Attention Line.     

 

For questions or additional information, call 601-353-3193 ext.215 or 800-890-5113 ext.215.

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