Affiliate Program Information Request

Please provide your company information below as it should appear in your 1040.com contract.

Required

Official company name

Doing business as (DBA)

Company street address

Suite/Unit

City

State

Zip

Company phone

Company website

Company president

EIN

EFIN

Main contact name

Main contact phone

Main contact e-mail address

Affiliate level you are interested in:

Referrer

Partner

Private Label

Questions/Comments

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