Skip to content
HOME
Forms
Onboarding
Preference Form
Billing Agreement
ACH Authorization Form Request
W-9 Request
Contact Us!
Service Area
Texas
Colorado
Tennessee
Florida
Georgia
Virginia
Key Systems
HOME
Forms
Onboarding
Preference Form
Billing Agreement
ACH Authorization Form Request
W-9 Request
Contact Us!
Service Area
Texas
Colorado
Tennessee
Florida
Georgia
Virginia
Key Systems
Our Service Areas:
•Texas
•Georgia
•Florida
Please fill out the following form. We would love to work with you!
Please enable JavaScript in your browser to complete this form.
Company Name
*
Owners Name
*
First
Last
Phone
*
Email
*
Fax
EIN/SS#
Billing Address
*
Address Line 1
Address Line 2
City
--- Select state ---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
How many properties do you manage?
Types of properties:
Number of doors:
Years in business:
Service Areas:
Who else is authorized to sign under this account? Please list Below.
*
Would you like to place a credit card on file for future payment?
*
Yes
No
Would you like to utilize the Mr.Rekey PM Key System?
*
Yes
No
Who can we deliver the key system to?
Number
Email
Do you use a property management portal?
Yes
No
Would you like us to:
Update the work order through the portal
Send invoices through the portal
Other
Other:
What is the name of the portal?
Account and Billing Terms:
Maximum Authorized Service Charge per Property:
Payment is Due within 30 days of the Invoice date Disclaimer.
By checking this box, I acknowledge and accept to pay Mr. Rekey Locksmith, a Rekey America Company, within 30 days of the invoice date.
Failure to Pay within 30 Days Disclaimer
By checking this box, I acknowledge and agree that Failure to Pay within 30 Days will grant Mr. Rekey Locksmith, a Rekey America Company, the right to charge my credit card on file for any unpaid invoices.
We apologize for any inconvenience. Our margin is small, and we need prompt payment from our billing accounts to keep our prices low.
Credit card information 💳
Name on Card
*
Credit Card Number
*
Expiration
*
Security Code
*
Is the Billing Address for the credit card the same as Mailing Address?
*
Yes
No
Address
Address Line 1
Address Line 2
City
--- Select state ---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Mr. Rekey ACH Information for Payment:
Bank: PNC Name: Rekey America Account: 4952646165 Routing: 071921891
Name of Person Submitting Form:
Submission Date:
For further clarification regarding questions or inquiries you may have, please reach out to us via phone at: 512-648-6464 or via email at: accounts_3@rekey.com
Submit