Commercial Core Seller Application

CUSTOMER/COMPANY NAME *

TAX ID/EIN

REPRESENTATIVE NAME

REQUIRED IF YOU ARE UNDER A BUSINESS, WILL REQUIRE IDENTIFICATION OF ALL REPRESENTATIVES

CUSTOMER/COMPANY ADDRESS *

PHONE *

FAX

EMAIL *

BUSINESS TYPE *

BUSINESS LICENSE *

DMV#

IF APPLICABLE

CONTACT NAME *

Signature *

Clear Signature

Custom Captcha *

=

File Upload

Click or drag files to this area to upload. You can upload up to 5 files.

UPLOAD IDENTIFICATION AND BUSINESS LICENSES OR CERTIFICATES HERE OR BRING THEM WITH YOU.

USK Recycling Inc