Harness Hardware Inc.

Dear Sir/Madam,
In regards to your request for a catalog & price list of our products, please complete the following. The reason we need this information is that we can only sell to qualified resellers. This information is important to make it fair for our existing customers. If you require hardware for your own use, please contact one of our dealers in your area. If you operate a resale outlet , please complete the following information, and a catalog & price list will be forwarded to you promptly.

Thank You,
Harness Hardware Inc.

Business Name:

Address:

City/Town:

Province/State:

Postal Code:

Telephone:

*enter phone number without dashes

Fax:

*enter fax number without dashes

Email:

Owner's Name

Vendor Permit/Tax Number

Corporation

Partnership

Proprietorship

How long in business at this location ?

Do you operate a retail outlet from this location?

Yes

N o

If yes, out of where do you operate your business?

Warehouse

Store

Home

Approximate inventory value you carry

Nature of business

What type(s) of our products are you mainly interested in

Signature

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