-
Full Legal Names(*)
Invalid Input
-
Trade Style (if used)
Invalid Input
-
Owner(s) Name(s)
Invalid Input
-
Address (Street)(*)
Invalid Input
-
City / Town(*)
Invalid Input
-
State / Province(*)
Invalid Input
-
Zip / Postal Code
Invalid Input
-
Country(*)
Invalid Input
-
Email(*)
Invalid Input
-
Telephone Number(*)
Invalid Input
-
Fax Number
Invalid Input
-
Billing Address (if Different)
Invalid Input
-
Person(s) Responsible For Payment
Invalid Input
-
Number Of Years In Business(*)
Invalid Input
-
Number Of Employees
Invalid Input
-
Estimated Purchase Requirement
Invalid Input
-
Subsidiary/ Division/ Affiliation
Invalid Input
-
Tax/GST/HST/Fed Id. No. (*)
Invalid Input
-
Are Transformers for Resale, own use or other? Provide Details(*)
Invalid Input
-
Credit Limit Desired
Invalid Input
-
Payment Pattern
Invalid Input
-
Banking Information (Institution, Branch, Adress)(*)
Invalid Input
-
Major Supplier #1 (Name & Phone Number)
Invalid Input
-
Major Supplier #2 (Name & Phone Number)
Invalid Input
-
Major Supplier #3 (Name & Phone Number)
Invalid Input
-
(*)
-
By Clicking "submit", you herby certify that the above information about the said organization is correct, and you permit Rex Power Magnetics to further verify this information to their current standards.
-