Credit And Trade References
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1
2Credit and Trade References
5795 Thurston Avenue • Virginia Beach, VA 23455 • Phone: 757-464-1755 / 800-825-4300 • Fax: 757-464-2054 / 800-288-8953 •
Bill To Information
Ship To Information
Company Name:
Company Name:
Address:
Address:
City, State & Zip Code:
City , State & Zip Code:
County:
County:
Phone:
Phone:
Fax:
Fax:
E-mail:
E-mail:
Accounts Payable Contact:
Sales Contact:
Parts Contact:
Service Contact:
Labor Rate:
General Company Information
Federal Tax ID #:
Principal Offi cer:
Dunn & Bradstreet #:
Title:
Legal Structure:
Purchase Order Required:
Yes
No
Tax Exempt:
In Business Since:
(Attach copy of exemption)
Yes
No
Business Type:
Tax Exempt #:
Honda Engines
Honda CBU
Country Clipper
Timberwolf
Jacto
Bluebird
Interested In:
(Please check all that apply)
Belle
Hustler
Plugr
Prizelawn
Monster
EZ Trench
Bank References
Bank Name (#1):
Bank Name (#2):
City/State:
City/State:
Contact/Phone:
Contact/Phone:
Trade References
Company
Address
Fax/Account #
1.
FX
Contact:
Acct
2.
FX
Contact:
Acct
3.
FX
Contact:
Acct
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Form Ttb F 5000.24sm - Excise Tax Return - Alcohol And Tobacco Tax And Trade Bureau (ttb) Of Department Of The Treasury - 2016
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Related Categories
Parent category: Business