Original Date: :
 MM/DD/YY
Project Manager:

COLITE INTERNATIONAL ACCOUNTS RECEIVABLE QUESTIONNAIRE

All questions contained in this questionnaire are strictly confidential

and will become part of your customer record.

Customer Name:
Customer Number:
Customer Billing Address:
Address Line 2:
Contact Name:
Contact E-mail:
 
Payment Information:
Method of Receiving Invoices:
 E-mail Regular Mail Federal Express
Person to Receive and Process Invoices:
Accounts Payable Phone Number:
Accounts Payable Contact Name:
Customer's Payment Terms:
Colite's Payment Terms are Net 30:
Customer's Payment Method:

Check Wire Transfer

Credit Card (we take Visa/MasterCard)
 
Comapany Information:
Tax Exempt Number (please send certificate):
 
Company Requirements:
Do you require a PO Number on your invoice?
Yes No
Do you require that a copy of your Purchase order accompany our invoice?
Yes No
Do you require any additional information to accompany our invoice?
Yes No
If yes please list all required information: