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ONLINE BILLING AND CUSTOMER MANAGEMENT SOLUTIONS

WELCOME TO XACTIBILL™ - FREE TRIAL ACCOUNT SET UP

YOU MUST FILL OUT THE FORM COMPLETELY

We offer a 15 day Free Trial of our Online Billing Program Xactibill™. This will give you the opportunity to see how this program will save you TIME and MONEY. We know that once you try Xactibill™ you will never look back. You Clients will be impressed the first time they are notified that they have a billing ready for their review online. The best part is the Client Log in Customized webpage branded with your Companies Logo. No More Stamps, Overnights all done Online - Online Billing has Evolved - Get Start Today!!

You will Receive your Log In information Via the Email you Specify on this Form

Your Free Trial is for 15 Days - What type of an Account would you be interested in after your Free Trial Expires?	Ultimate Premium Lite Single
Company Name:
What is your Primary Business?
Mailing Address:
City, State, Zip
Office Phone:
2nd Contact Phone:
Your Company Website URL:
Email Address:
First Name:
Last Name:
Log In Username:
Enter a Temporary Password:
Administrator Email Address:
What is your Time Zone:
Upload your Company Logo for your Custom Billing Webpages: Logo Size should not Exceed 150px x 150px ( Ideal Size is 150px x 75px) Formats accepted - jpg, png, gif (FOR PAID SUBSCRIPTIONS ONLY)
Upload your Company Logo that will be displayed on your Billing Pages and Invoice: Logo Size should not Exceed 200px x 150px (Ideal Size is 150px x 65px) Formats accepted jpg, png, gif (FOR PAID SUBSCRIPTIONS ONLY)
Before an Account is Set up you Must Read and Agree to the User Agreement and End User License Agreement. To view these agreements Click on the Menu Above Agreements. (YOU MUST HAVE 2 BOXES CHECKED FOR EACH AGREEMENT)	1) I Certify that I have Read the User Agreement for Xactibill a) I Agree with User Agreement b) I Disagree with User Agreement 2) I Certify that I have Read the End User License Agreement (aka EULA) for Xactibill a) I Agree with the EULA b) I Disagree with the Eula
Would you like to Set up your Account for Automatic Payments? (This will continue your Subscription Monthly)	Yes No I would Like to Leave this as an Option
Database Set Up - We offer a Service that will Take your Current Pricelist and Convert it to the Proper Format for Xactibill. If you are Interested Please Check Yes and we will Evaluate your Pricelist and Submit a Proposal for this Service. (FOR PAID SUBSCRIPTIONS ONLY)	Yes No Send Me More Information
If you Checked Yes on the Database Setup - Please Upload your Pricelist Here. We will Evaluate and Send you a Proposal for these Services. (FOR PAID SUBSCRIPTIONS ONLY)
Xactibill is Compatible with Contractor Billing Solutions® a Desktop Version - This allows you the Opportunity for Online and Offline Billing. Would you Like More Information on Contractor Billing Solutions®?	Yes No
Please Add any Questions or Comments Here:

Once you Subscription is Paid - You will be directed to a Set Up Page - Make sure you Fill this Page Out Completely as this is used to Create Your Account.

By the Time You Can Say The Bill is In the Mail you Could Have Already Delivered the Bill to the Client if Your Were Billing Them with Xactibill™

Xactibill ™ can be customized by using the tools that are provided with every program. Customization allows you to make this program look and feel like your company. Clients log in and they have their own webpages - but what they see is a website branded with your company information. Finally a cost effective ONLINE BILLING PROGRAM that Starts at less than $1.00 Per Day. How can we do this? Because We Want to - We Designed and Developed Every Feature you Will See - Making this OUR Program and with that We Decide HOW MUCH!!

ONLINE BILLING - GET PAID FASTER - YOUR CLIENTS CAN APPROVE THIER BILLINGS ONLINE ON THEIR OWN WEBPAGE BRANDED WITH YOUR LOGO - YOU GET IMMEDIATE EMAIL NOTIFICATION - NEED TO SEE IF THEY LOG ON? NO PROBLEM CHECK THE LOG IN ACTIVITY LOG

XACTIBILL™ ONLINE BILLING IS A SECURED SSL WEBSITE

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