All fields marked with * (asterisk) are mandatory.
If you answered No to any of the above three addresses, please fill out the address on part 3 of this form below.
DUNS Number - This number is assigned by Dun & Bradstreet :(9-digit number without spaces or dashes)
UCC Company ID NUMBER - This is the first 6 or 8 digits of your UPC number (6 or 8 digits)
Phone Number ID:* This is your phone number including area code without dashes, spaces or parenthesis (Example: 7139330590, Maximum: 15 characters)
Your Main EDI contact person at your company:
Name:*
E-Mail:*
Telephone:*
Cell Phone: