Customer Contact Information

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All fields marked with * are required.

Customer Contact Information - Accounts Receivable

CORPORATE ADDRESS:

Company Name: *

Attention: *

Street Address: *

City: *

State: *

Zip: *

Phone Number: *

Shipping address is the same as the corporate address? *

*If you answered NO, please fill out the shipping address below.

SHIPPING ADDRESS:

Company Name:

Attention:

Street Address:

City:

State:

Zip:

Phone Number:

Prefered Contact Method: *

Mail
Email

BILLING INFORMATION:

United Ag & Turf can deliver your statements by email and we are able to deliver to multiple email addresses. Please provide us with the email addresses for invoice and statement delivery below.

INVOICES:

Email:

STATEMENTS:

Email:

Customer Contact Information

CORPORATE ADDRESS:

SHIPPING ADDRESS:

BILLING INFORMATION:

INVOICES:

STATEMENTS:

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