* Publishing Company Name:
* Street Address:
* ZIP/Postal Code:
* Name of Key Contact:
If Yes, the number(s) is (are)
If Yes, the number(s) is:
Number of titles for which BIPAD numbers are to be allotted
. (A different BIPAD number
must be used with each title publication for which separate distribution records are to be
maintained by wholesalers. It is not necessary to obtain a different BIPAD number for each issue.)
Credit Card Type:
Credit Card Number:
Name (as appears on credit card):
Expiration Date (month/year):
**Please note: This charge will be under the name of HARRINGTON ASSOCIATES on your statement.
FEE SCHEDULE *
* Multiple number fee rates are not
retroactive and are available only at time of original application.
Effective February 1, 2014
NAME OF TITLES
(A different BIPAD number is required for each title, but not
for each issus.
NUMBER OF MAGAZINE WHOLESALERS:
NAME OF MAGAZINE WHOLESALERS/DISTRIBUTORS
If you have trouble using the online form or do not receive an email confirmation, please feel free to submit your
request using the PDF format by Fax to 508-819-4926 or scan and send with an email to firstname.lastname@example.org Phone: 401 213-6830.
BIPAD Inc. provides the administration of a uniform and non-discriminatory number coding system for