ASAP Relocations - Corporate

Fields marked with a * are required

General Information

Legal Name of Company (Applicant):

*

Business Address:

*

Billing Address:

*

City:

*

State:

*

Zip Code:

*

Telephone:

*

Sole Partnership Partnership Corporation

Country:

State:

Date Business Opened:

-

(DD/MM/YYYY)*

Federal I.D. # (FEIN)

The Owners, Partners, Officers and/or Principal Stockholders of the Company are:

Name

Direct Phone / Ext.

Position

% Owner

Nature of your business:
No. of Employees:
DUNS#
Years in Business:
Is your company/Location a:	Corp. Headquarters Branch Subsidiary Other *

Are Purchase Orders Required?	Yes No
Person to contact regarding Accounts Payable:
Persons Authorized to Schedule Relocation Service:	1) 2) 3)

Types Of Service Required For Your Company (Please check all that apply)

Personal Moving
Office Relocation
Real Estate Disposition
Local/In-State Relo.
Nationwide Relo.

Trade References:

Name

Address

Tel/Fax

Contact Person

Bank References:

Name

Address

Account No.

Telephone & Contact

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