Client - Updated Information

In order to update our dispatch software and accounting system, we would like you to answer the questions below. This will allow us to have your accurate and current information in the future.

Company Information Company Name ^* Legal Company Name ^* Industry ^* Website ^* Email ^* Address ^* City ^* Prov / State ^* ZipCode ^* Country ^* Phone ^* Toll Free ^* Fax ^* Language ^* Time Zone ^*

Taxes Tax ID ^* Tax Country ^*

Main Contact

If you want to add additional email addresses, please separate with a semicolon ;

Full Name ^* Title ^* Phone ^* Mobile ^* Email ^*

Pick-up and Delivery Contact Full Name Title Phone Mobile Email

Accounting Contact Full name ^* Title ^* Phone ^* Mobile ^* Invoicing Email ^* Account Statement Email ^*

Shipping Requirements

Please select those requirements needed.

TailgateIn-Side DeliveryB TrainDouble DeckDrop DeckDry VanFlat BedJiggerReeferRolltiteStep DeckStraight BodyTail GateWhite Glove Service

Appointment Required

Warehouse hours of operation Monday from ^* Monday to ^* Tuesday from ^* Tuesday to ^* Wednesday from ^* Wednesday to ^* Thursday from ^* Thursday to ^* Friday from ^* Friday to ^*

Accessibility Highway TrucksCity TrucksLoading DockNo touch contactTailgate

Custom Broker Information Import Custom Broker ^* Export Custom Broker ^*

Specify the name of your import broker

Only edit this fieldset if “Import Custom Broker” is set to “Other”.

Name of import custom broker

Specify the name of your export broker

Only edit this fieldset if “Export Custom Broker” is set to “Other”.

Name of export custom broker

Operation Reports Email for Operation Reports ^*

Please fill all the letters into the box to prove you're human. Y W Y R H Please keep this field empty: