New Client Information | Logical Systems, LLC

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Legal Name of Company(Required)

Name of person submitting this form(Required)

Email(Required)

Phone(Required)

Are you also the accounts payable contact?(Required)

Yes

Accounts Payable Contact(Required)

Email(Required)

Purchasing Contact(Required)

Email(Required)

Phone

Comments/Special Instructions

Billing Address

Street Address(Required)

Address Line 2

City(Required)

State / Province / Region / County(Required)

Zip / Postal Code(Required)

Country(Required)

Federal ID #(Required)

DUNS #

Tax Exemption

Is the work performed for your company exempt from sales and use tax?(Required)

Yes (attachment required)

Exemption Number(Required)

Bank Information

Name of Bank

Street Address

Address Line 2

City

State / Province / Region / County

Zip / Postal Code

Country

Bank Contact Name

Phone

Email Address

Trade Reference 1 of 3

Name of Business

Street Address

Address Line 2

City

State / Province / Region / County

Zip / Postal Code

Country

Contact Person

Phone

Email Address

Trade Reference 2 of 3

Name of Business

Street Address

Address Line 2

City

State / Province / Region / County

Zip / Postal Code

Country

Contact Person

Phone

Email Address

Trade Reference 3 of 3

Name of Business

Street Address

Address Line 2

City

State / Province / Region / County

Zip / Postal Code

Country

Contact Person

Phone

Email Address

Which LSI Branch Office are you working with?(Required)

Name of LSI contact you are working with?(Required)

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