Register - Importrus

IDENTIFICATION

Trade name*

Legal name*

Phone*

Kind of company

Incorporated
Limited
Registered

Fax

Email*

Type of business

Established since*

SHIPPING ADDRESS

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Owner / shareholder*

First Last

Building owner*

Yes
No

Account payable clerk*

Terms of sale required / day*

Credit required ($)*

BILLING ADDRESS

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Owner phone number*

City*

Phone Number*

Statement*

Yes
No

By fax*

Yes
No

By e-mail

BANK REFERENCE

Name of the bank*

Phone*

Address*

Branch*

Account number*

Dealing since*

SUPPLIER REFERENCE (PREFERABLY MEAT & FOOD INDUSTRY)

Reference 1

Phone number 1

Reference 2

Phone number 2

Apply for a credit account

IDENTIFICATION

SHIPPING ADDRESS

BILLING ADDRESS

BANK REFERENCE

SUPPLIER REFERENCE (PREFERABLY MEAT & FOOD INDUSTRY)

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