Builder/ Dealer Information Sheet
Today's Date
/
Month
/
Day
Year
Date
Name of Business
*
Tax Identification No
*
Business Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Mailing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Owner/Point of Contact
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Fax Number
-
Area Code
Phone Number
Email Address
*
example@example.com
Product Line
i.e. barns, swing sets,gazebos
Average yearly units sold:
Peak Season:
Spring
Summer
Fall
Winter
Days/ Hours of Operation:
References
Bank Contact
Bank Phone Number
-
Area Code
Phone Number
Vendor Contact
Vendor Contact Phone Number
-
Area Code
Phone Number
Submit
Should be Empty: