Contact AP-AR Department

Company Name
Customer Number
Billing Address Billing Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Phone - ### - ### ####
Fax Fax - ### - ### ####
Is the Shipping Address the Same?

Is the Shipping Address the Same? Yes
Shipping Address Shipping Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Phone - ### - ### ####
Fax Fax - ### - ### ####
Email
Accounts Payable Contact Name Accounts Payable Contact Name First Last
Type of Organization

Type of Organization Partnership Corporation Gov't Non-Profit Proprietorship Other
Name of Owner(s) | Corporate Officer(s)
Please attach all necessary forms
What Tri-Lift NJ Departments will you be dealing with?

What Tri-Lift NJ Departments will you be dealing with? Sales Service Parts Rental