Customer Resources
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Name

Tax I.D. Number

Name of Business

Business Address

Email

Phone Number

Type of Business

In Business Since

Legal Form Under Which Business Operates
CorporationPartnershipProprietorship

If Division/Subsidiary, Name of Parent Company (If Applicable)

Parent Company In Business Since (If Applicable)

Name of Company Principal Responsible for Business Transactions (If Applicable)

Address of Company Principal Responsible for Business Transactions (If Applicable)

Bank Name (If Applicable)

Checking Account # (If Applicable)

Bank Routing # for ACH (If Applicable)

Credit Card # (If Applicable)

Credit Card Exp Date/CSV (If Applicable)

Trade Reference Company Name

Trade Reference Contact Name

Trade Reference Contact Phone #

Trade Reference Company Address

Trade Reference Company Account Opened Since

Trade Reference Company Account Credit Limit

Trade Reference Company Account Current Balance

Anything Else?