Email: Sales
Web Address: http://www.marshallslocks.com/
| Company Name:_____________________ | Phone:______________ | Fax:______________ | |
| Address:___________________________ | City:________________ | State:_______ | Zip:_______________ |
| Billing Address:____________________________ | City:__________________ | State: ___ | Zip:_______ |
| Billing Contact:_____________________________ | Phone:_________________ | Fax:________________ | |
| Email:____________________________________ | |||
| Type of business:_________________ | Established:___________ | At Current Address Since:_______________ |
| Employer ID No.:__________________ | Owner's Social Security No.: _______________________________ | |
| Business Structure: Corporation_______ Partnership______ Sole Proprietorship______ Individual______ | ||
| Tax Exempt no., If Applicable:________ | Credit Amount Requested: $__________________________ | |
| Do you require Purchase Orders? Yes _______ No________ | ||
Names of Corporate Officers, if applicable:
| President:___________________________________ | Vice President:___________________________________ |
| Treasurer:__________________________________ | Other:____________________________________ |
Bank Reference:
| Bank:______________________________________ | Branch:_________________________ | Acct. no.:_____________ | |
| Address:____________________________________ | City:____________________ | State:____ | Zip:___________________ |
Trade References:
| 1) | Company:_____________________________________________ | Address:_____________________________ | |||||
| Contact:_______________________________________________ | Phone:____________ | Fax:_______________ | |||||
| 2) | Company:_____________________________________________ | Address:_____________________________ | |||||
| Contact:_______________________________________________ | Phone:____________ | Fax:_______________ | |||||
| 3) | Company:_____________________________________________ | Address:_____________________________ | |||||
| Contact:_______________________________________________ | Phone:____________ | Fax:_______________ | |||||
I/we understand and agree to the following and will abide by Marshall's company requirements.
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