Forms & Instructions

Account Set-up Forms

Credit Application

Complete this form and fax it to our New York office or to your local sales office to establish your credit, for open-account billing.

Technician Certification Form

Complete this form and attach a copy of the EPA certification card for at least one of your employees, so that we can enroll you in our database, allowing your company to purchase regulated CFC and HCFC refrigerants.

W9 form for Airgas Refrigerants, Inc.

This form will provide you with company information for Airgas Refrigerants, Inc., such as corporate status, address and our Taxpayer Identification Number (TIN).


Sales Tax Exemption Certificate

Commonwealth of Virginia

Complete this form for your state or the multi-jurisdiction form and fax it to our New York office for processing. Fax: 718-392-0675

Florida

Complete this form for your state or the multi-jurisdiction form and fax it to our New York office for processing. Fax: 718-392-0675

Indiana

Complete this form for your state or the multi-jurisdiction form and fax it to our New York office for processing. Fax: 718-392-0675

Louisiana

Complete this form for your state or the multi-jurisdiction form and fax it to our New York office for processing. Fax: 718-392-0675

Multi-Jurisdiction Form

Complete this form for your state or the multi-jurisdiction form and fax it to our New York office for processing. Fax: 718-392-0675

NY Form

Complete this form for your state or the multi-jurisdiction form and fax it to our New York office for processing. Fax: 718-392-0675

West Virginia

Complete this form for your state or the multi-jurisdiction form and fax it to our New York office for processing. Fax: 718-392-0675

Wyoming

Complete this form for your state or the multi-jurisdiction form and fax it to our New York office for processing. Fax: 718-392-0675


Procedures for Cylinder Returns

Defective Cylinder Claim Form with Instruction sheet

If you have received a cylinder from Airgas Refrigerants that you believe to be defective, complete this form according to the accompanying instructions and fax it to us. We will then contact you to arrange for an inspection.

Instructions for Returning Empty Product Cylinders

Step by step instructions for properly returning empty returnable cylinders to Airgas Refrigerants.