Quincaillerie Lion Hardware

Create a Client Card

Creating your client card will help us get to know and serve you better.

Company Name: *

Address: *

City: *

Province/State: *

Postal Code/Zip Code: *

Country: *

Telephone: *

Fax: *

Email:

Owner's Name: *

Telephone:

Bank Name: *

Telephone: *

Address: *

City: *

Person in charge of accounts payable:

Email:

Sales Taxe Number:

Type of Business:

Store Buyer:

Is a Purchase Order required? *

Supplier Name and Telephone Number:

Plastic company with whom you do business:

Name the person authorized to do this request: *

Title: