CLIENT FORM Last Name _______________ First Name ___________ Title _______ Spouse ___________ Company Name _____________________________ Company Id # _________ Street address _____________________________ City / State _____________________________ ZIP _______ Home phone (___) ___-____-____ Total purchases _________ Work phone (___) ___-____-____ Credit Terms _________ last contact date ________ Credit Rating _ Mailing times weekly __ bi-weekly __ monthly __ bi-monthly __ Comments ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ Post Script ____________________________________________________________________  E//C:C CC % %*7H     DDDD              ZIP W. PHONE4 W. PHONE3 W. PHONE2 W. PHONE1 TOT PURCH.TITLE STREET AD. SPOUSE LAST NAME L CONTACT H. PHONE4 H. PHONE3 H. PHONE2 H PHONE1 FIRST NAME CR. TERMS CR. RATINGCOMPANY IDCOMPANY CITY/STATEH. PHONE2 H PHONE1 FIRST NAME