| Reel Men - New Customer Information Sheet |
| Company Name: |
_______________________________ |
Time In Business:____________ |
| Type of Company: |
Incorp.______ Partnership______ |
DBA:_________________________ |
| Job Contact Name: |
_______________________________ |
Phone:_______________________ |
| Company Address: |
_______________________________ |
Phone:_______________________ |
| |
_______________________________ |
Cell:________________________ |
| |
|
Fax:_________________________ |
| Billing Address: |
_______________________________ |
|
| (If different) |
_______________________________ |
|
| |
|
|
| Accounting Contact Name: |
_______________________________ |
Phone:_______________________ |
| |
_______________________________ |
|
| |
|
|
| Owners, Principals, Officers: |
|
|
| Name:_______________________ |
Address: |
Phone:_______________________ |
| Title:______________________ |
_______________________________ |
Cell:________________________ |
| SSN:________________________ |
_______________________________ |
|
| |
|
|
| Bank Reference: |
|
|
| Bank Name:__________________ |
Location:________________________ |
Phone:_______________________ |
| Account#:___________________ |
Account Type:____________________ |
|
| |
|
|
| How did you hear about us? ________________________________________________________ |
