New Customer Contact Information Form | International Magnaproducts, Inc.

Company Information

Company Name *

Company Website *

DUNS Number *

Street Address Line 1 *

Street Address Line 2

City *

State/Providence *

Zip/Postal Code *

Country/Region *

EDI Provider

C-TPAT

Are you C-TPAT Certified?

Yes

No

Please Provide SVI Number

Contact Information

Primary Buyer

Primary Buyer Last Name

Primary Buyer First Name

Primary Buyer Email

Primary Buyer Phone/Extension

Primary Buyer Fax

Secondary Buyer

Secondary Buyer Last Name

Secondary Buyer First Name

Secondary Buyer Email

Secondary Buyer Phone/Extension

Secondary Buyer Fax

Scheduler/Planner

Scheduler/Planner Last Name

Scheduler/Planner First Name

Scheduler/Planner Email

Scheduler/Planner Phone/Extension

Scheduler/Planner Fax

Accounts Payable

Accounts Payable Last Name

Accounts Payable First Name

Accounts Payable Email

Accounts Payable Phone/Extension

Accounts Payable Fax

Quality Manager

Quality Manager Last Name

Quality Manager First Name

Quality Manager Email

Quality Manager Phone/Extension

Quality Manager Fax

Shipping/Receiving

Shipping/Receiving Last Name

Shipping/Receiving First Name

Shipping/Receiving Email

Shipping/Receiving Phone/Extension

Shipping/Receiving Fax

EDI Contact

EDI Contact Last Name

EDI Contact First Name

EDI Contact Email

EDI Contact Phone/Extension

EDI Contact Fax

Additional Information

Additional Information that would be beneficial to IMI

Leave this field blank

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