
C.P. 202, Succursale C, Montréal (Québec) H2L4K1
CUSTOMER FORM
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NEW CUSTOMER APPLICATION FORM |
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| Legal Name : | ||
| Owner Names : | ||
| Sector of activity : | ||
| Year Established : | ||
| PST # : | GTS # : | |
| Ship to Address : | Bill to address : | |
| Contact : | Contact : | |
| Telephone : E mail : |
Fax : | |
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BANK INFORMATION |
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| Name and Complete Address : | Account # : | |
| Credit line : | ||
| Contact : | ||
| Telephone : ( ) | ||
| Fax : ( ) | ||
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TRADE REFERENCES |
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| Companies and addresses | Tel # | Fax # |
| ( ) | ( ) | |
| ( ) | ( ) | |
| ( ) | ( ) | |
UPON COMPLETION, PLEASE FAX NEW CUSTOMER APPLICATION FORM TO : (450) 467 5443, (514) 525 5044
Signed : _____________________________________________________________
