"Tri-Star Industries, Inc"
Tri-Star Industries, Inc. Customer Profile – Credit Card Purchases To: Tri-Star Sales Department Fax: 860-828-7475 From: Fax: 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. Company Name: Main Address: City, State & Zip Main Phone: Main Fax: Purchasing Contact: Payable Contact: Ship to Address:* *If this is a residential address please check box #1 #2 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 * Page 1 of 1