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LUEDTKE LUMBER - ACCOUNT APPLICATION
Welcome to Luedtke Lumber True Value. Thank you for applying for an in house charge account. Please fill out your information below and we will be in contact with you.
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Email
*
Your answer
First Name
*
Your answer
Last Name
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Account Name (Business name, or as you would like it to appear on the account)
*
Your answer
Business Type
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Corporation
Sole Proprietorship
Individual
Nonprofit
Other:
Business Owner full name
Your answer
# of Years in Business
Your answer
Street Address (Physical Location
*
Your answer
City
*
Your answer
State
*
Your answer
Tax Exempt
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Yes (please email your tax exempt for to us beth (at) luedtkelumber (dot) com
No
Please provide your Tax Exempt #
*
Your answer
Email address (to receive invoices and statements)
*
Your answer
Email address (for marketing and company updates)
Your answer
Cell Phone
*
Your answer
Other Phone (please indicate type)
Your answer
Please email any business references you would like to go along with your credit application to beth (at) luedtkelumber (dot) com
*
Column 1
EMAILED
Column 1
EMAILED
Do you require a PO
*
Yes
No
Authorized Buyer Names
*
Your answer
Full Name of Business Owner or CEO
Your answer
Address of Business Owner (Street, City, State Zip Code)
Your answer
Business Owner Birthday
MM
/
DD
/
YYYY
Business Owner Email
Your answer
Business Owner Phone Number
Your answer
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