Zreiss.com

CALL US: (800) 943-2000

To Become a Z. Reiss Customer, please fill out the form below and fax in your credit application to 718-510-8703.

1COMPANY INFORMATION

* Company Name

* Address 1

Address 2

* City

* State

* ZIP

* Tax ID #

2CONTACT INFORMATION

* Owner

* Buyer

Manager

3ORGANIZATIONAL FORM

Sole Proprietor

Partnership

Corporation

* Incorporation Date

* State Of Incorporation

* Has the firm or any principals ever been bankrupt?

Yes

4LOCATION/OPERATION

Home

Commercial Building

Own

Rent

* Numbers of
Employees

* Years in
Operation

* Dunn & Bradstreet #

Annual sales volume *

$1,000,000 - $5,000,000

$5,000,000 - $10,000,000

or $

SUBMIT APPLICATION