New User Registration

Email * EMAIL - MAIN ACCOUNT EMAIL FOR LOGGING IN AND MARKETPLACE COMMUNICATIONS

Email #2 EMAIL #2 - EMAIL FOR NOTIFICATIONS

Email #3 EMAIL #3 - EMAIL FOR NOTIFICATIONS

Phone Number1 *

EXT:

Phone Number2

EXT:

Address Line 1 *

Address Line 2

Address Line 3

City *

State/Province/Region *

Zip/Postal Code *

Country *

If Other Country, Please Specify

COMPANY WEBSITE ADDRESS

Provide your Max # of truck loads preferred by facility

8615

8616

8617

8618

Please arrange pickup directly with the facility listed below:

8615

1390 S. Perry Road, Plainfield, IN 46168
(317) 821-0081
shipping8615@homedepot.com

8617

7200 W. Buckeye Road Phoenix, AZ 85043
(623) 707-1824
shipping8617@homedepot.com

8616

180 Westridge Parkway McDonough, GA 30253
(770) 288-3590 x528
shipping8616@homedepot.com

8618

200 Technology Dr, Pittston, PA 18640
(570) 300-6400
shipping8618@homedepot.com

Provide preferred categories and mix of trucks by facility Select what categories you are interested in purchasing by facility

Please provide any additional information/details regarding your current business model structure or needs (Max. 200 char):

Customer State Certificate form * :

(Acceptable Company State Certificate File Format: PDF,JPG,DOC,RTF,PNG,DOCX,JPEG)

W9 Form/Tax Certification or any tax form * :

(Acceptable W9 File Format: PDF)

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