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Email
Name of firm or individual	Years at this address
Address	Phone
City State CA Zip	Fax:
Corporation Partnership Individual
Officers or Owners
Date Business Started January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31	Resale Number
Type of Business	Any Bankruptcies? No Yes
A/P Contact	Buyers Name
Trade References
Company	Address
Phone	Fax
Company	Address
Phone	Fax
Company	Address
Phone	Fax
Company	Address
Phone	Fax
Bank Name	Account Number
Address	Contact
Phone	Fax
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