Tri-Star Industries, Inc.
Customer Profile – Credit Card Purchases
To: Tri-Star Sales Department Fax: 860-828-7475
In order for us to set up your account and ship your order, please complete this form and fax it to
860-828-7475. Your prompt response will be appreciated.
City, State & Zip
Main Phone: Main Fax:
Ship to Address:* *If this is a residential address please check box
Other Key Personnel:
Contact Name: Title: Phone: Ext. Email:
Business Type: Please check one of the following:
Automotive Distributor Engineering Manufacturer Molder OEM Other
Sales Tax I.D. # Referred to Tri-Star by:
Most shipments are made via UPS on a “prepaid & add” basis. If you prefer “UPS Collect” please list your
UPS Account Number below. Also, if applicable, please identify a trucking company as an alternate carrier.
UPS Account No.:_____________________ Common Carrier/LTL: ______________________
* Thank You – Tri-Star Industries *
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