Open an Account: Grating Fasteners: Fax (504) 366-1049

Open an Account with Grating Fasteners, LLC

Please Print Out and return the following form.
PLEASE NOTE: Use our form for a reply within one working day.
Note that if you use your own form, please use complete data for a faster response.

New Customer Questionnaire

Bill to Name:

Billing Address:

City & State:

ZIP (Please include your nine-digit zip code to speed delivery):

IMPORTANT Your Fax Number:

Ship to Name:

Shipping Address:

City & State:

ZIP (Please include your nine-digit zip code to speed delivery)

Do you have more than one receiving location? [ ] Yes [ ] No

If yes, do you pay from each location, or from a single location?

President / Owner:

Controller:

Federal I.D. No:

Date and State of Incorporation:

Are purchases subject to sales tax? [ ] Yes _______Rate [ ] No

Please describe the nature of your business:

Estimated annual purchase of grating fasteners: $

Are purchase orders required? [ ] Yes [ ] No

Telephone #

Fax #

Purchasing Agent is:

Telephone #

Fax #

Company e-mail address is:

Your Website address is:

Accounts Payable Manager:

Telephone #

Fax #

Dun & Bradstreet #

Opening a New Account

We offer net 30 day terms to established customers. Please furnish us with the following references, so that we might consider opening an account for your company.

1. Bank References:

Bank Name

Account Number

Address

Contact Person

Phone/Fax

2. Four Trade References:

Name:	Address:	Contact Person:	Phone Number	Fax Number

This information should be sent VIA FAX to our accounting department at (504) 366-1049 to establish credit. Then, please mail original copies to the following address: Grating Fasteners, LLC, P.O. Box 6438, New Orleans, LA 70174-6438. Thank you.