iLoveToCreate | Register

New Or Existing Duncan Customer:

New Customer Existing Duncan Customer

Customer No:

Your Personal Details

Company name:

First name: *

Last name: *

Title:

Email: *

Phone:

BILLING ADDRESS

Country: *

State / province:

City: *

Zip / postal code: *

How Long At Current Address:

Address 1:

Address 2:

Payable FirstName:

Payable LastName:

Phone number: *

Email: *

Shipping Address

Same As BillingAddress:

Ship To Address Type:

Residential Business

Country: *

State / province:

City: *

Zip / postal code: *

Address 1: *

Address 2: *

Phone number: *

Email: *

NOTES FOR CARRIER

If shipping LTL, will you need a liftgate?:

Yes No

Delivery Appointment Required?:

Yes No

Warehouse Contact FirstName: *

Warehouse Contact LastName: *

Warehouse Contact PhoneNumber: *

Date Business Commenced:

Sole Proprietorship:

Partnership:

Corporation:

Other:

Please attach copy of resale certificate. If no certificate is provided, all sales will include sales tax

Additional Notes:

Register

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