Electronic Funds Transfer Application 1 Step 1 Retail Partner Information Company Name Address City State Zip Code Buyer/Contact Name Buyer/Contact Email Buyer/Contact Phone Bank Information Bank Name Bank Address Bank City Bank State Bank Zip Code Bank Contact Name Bank Contact Phone Bank Contact Fax Bank Account Number Bank ABA Routing Number Retail Portal Access Setup Form The BudPayments.com website is a self-service tool in which summary and invoice level payment information is accessible for A-B wholesaler deliveries. If you would like to gain acess to this site, please complete the information below. Retailer Name Name of User User Email Addressemail User Address User City User State User Zip Code User Phone Authorization Yes! I authorize Terrance A. Smith Distributing to use the information submitted for electronic funds transfer.Yes Please attach an image of a voided check:uploadcloud_upload Submit Application keyboard_arrow_leftPrevious Nextkeyboard_arrow_right FormCraft - WordPress form builder
