Customer Registration

Terms and Conditions

Before submitting your application please read the Terms and Conditions as specified in the account agreement listed below.

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Requested Services

Choose One: Tax ExemptionCharged Sales AccountBoth

Customer Information

*Organization Name FEIN/EIN *Organization Type

The organization name can be up to 30 characters. If the name exceeds this limit, please shorten the name to what you wish to see on all correspondence.

Primary Contact

*First Name *Last Name

*Telephone - - Fax - -

Email Address

Confirm Email

*Position

Primary Address

*Address 1

Address 2

*City

*State

*Zip Code

Charged Sales Account Information

*What is your expected monthly purchase amount with Dollar General?

*We encourage you to help us protect your account when purchasing goods or services by selecting from one of the following options:

Bank Reference

*Bank Name *City *State

*How long has your organization used this bank as your primary bank?

Years

*Bank Telephone - - *Bank Fax - -