We ask all new customers to fill out a credit application.
Completed forms from Indiana customers may be faxed to 812-522-3242, mailed to PO BOX 304, Seymour, IN 47274, or dropped off at 811 W. 2nd Street, Seymour, IN 47274.
Completed forms from Ohio customers may be faxed to 513-367-6876, or mailed or dropped off at 111 May Drive, Harrison, OH 45030.
- Individual Credit Application: If you are an individual seeking our products or services, click here to download a copy of our credit application.
- Commercial Credit Application: If you are a commercial business or organization, click here to download a copy of our credit application.
- ST105 Tax Exempt Form: Indiana registered retail merchants and businesses located outside Indiana may use this certificate to claim a sales tax exemption for valid purchases.
- ACH Authorization Form
- Indiana GA-110L Claim for Refund
- Indiana REF-1000 Claim for Fuel Tax Refund
- Kentucky 72A110 Certification of Motor Fuels Nonhighway Use
- Kentucky 72A135 Application Motor Fuel Tax Refund Permit
- Kentucky 51A158 Farm Exemption Certificate for Sales Tax
- Employee Application: Fill out this form and e-mail it to email@example.com
- Input Finance Program: Click here to download our Input Financing Loan Application
- W9 Form: W9 Request for Taxpayer Identification Number and Certification
- Upload a Document to Premier