to Be Used for Adding and Modifying Customer Records

The L. S. Starrett Company

Distributor Notice

- To be used for adding and modifying customer records–

Requested by: / Date:
Approved by: / Date:
Approved by: / Date:
Profile Class:
Collector: / Date:
Sales Group Code: / Buying Group Code:
Add: / Modify: / Remove: / Distributor #:
Official bill-to name and address:
Name:
Name:
Mailing Address:
Physical Address:
City: / State: / Zip:
Country: / Territory:
Telephone: / Fax:
Order Acknowledgment Email Address:
Marketing Email Address:
Accounts Payable Email Address: A/P Phone: Fax:
Projected Annual Sales: $ Estimated Initial Order: $

Classification

Construction / Saws Only / OEM
Full Line / Tools Only / Not Vision Systems
Government / Partial Line / Misc.
Product LinesX = (Extend PricingW = (Withdraw Pricing)
Full Line……………………. / MSD…………………………
Full Line (no MSD)………… / Optical…………………….
Tools………………………... / Vision……………………..
Tapes & Levels……………... / Granite Surface Plates……….
Flat stock/Drill Rod………… / Special Gaging………………
Saws………………...……… / Webber Gage………………..
Hack & Hole Saws………. / M-1 Oil……………………...
Jigs & Recips……………. / Parts & Cases………………..
Band Saws……………….. / Testing Equipment….……….
Force Measurement…….
Material Test…….…….

Sales Channel

Construction / Strategic / Internet/Catalog
Export / Traditional / Sales Rep
OEM / Tru-Stone / Testing Equipment
Special Gage / Webber
Special Order / Industrial Wholesale

The L. S. Starrett Company

DISTRIBUTOR SHIP - TO NOTICE

Add Modify Remove Requested byDate
Distributor I/D: Name: / Cust. No.
Address:
Address:
City: / State: / Zip: / Territory:
Ship to Phone #: / Fax #:
Address:
Address:
City: / State: / Zip: / Territory:
Ship to Phone #: / Fax #:
Address:
Address:
City: / State: / Zip: / Territory:
Ship to Phone #: / Fax #:
Address:
Address:
City: / State: / Zip: / Territory:
Ship to Phone #: / Fax #:
Address:
Address:
City: / State: / Zip: / Territory:
Ship to Phone #: / Fax #:
Address:
Address:
City: / State: / Zip: / Territory:
Ship to Phone #: / Fax #:
Address:
Address:
City: / State: / Zip: / Territory:
Ship to Phone #: / Fax #:
Address:
Address:
City: / State: / Zip: / Territory:
Ship to Phone #: / Fax #:
Address:
Address:
City: / State: / Zip: / Territory:
Ship to Phone #: / Fax #:

The L. S. Starrett Company

COMPANY CONTACTS

President: / Sales Manager:
Vice President: / Purchasing Agent:
Accounts Payable:
Accounts Payable Email Address:

BANK REFERENCES

Bank:
Address:
City: / State: / Zip: / Country:
Telephone: / Fax: / Contact:

CREDIT REFERENCES *

Company:
Address:
City: / State: / Zip: / Country:
Telephone: / Fax: / Contact:
Company:
Address:
City: / State: / Zip: / Country:
Telephone: / Fax: / Contact:
Company:
Address:
City: / State: / Zip: / Country:
Telephone: / Fax: / Contact:
Company:
Address:
City: / State: / Zip: / Country:
Telephone: / Fax: / Contact:

* Credit references should include companies with which they do business other than competitors.

Additional Comments:

The L. S. Starrett Company

Mailing Updates and Website Access

Distributor Name:
Distributor Account #: / City: / State: Zip:

Country:

Publication Mailing Contact Name:
Title:
Publication Mailing Address:
Same as Ship To Y/N
Same asBill To Y/N
Mailing Address, if different:
Industrial Tools (133W) / Industrial Granite (808W)
Industrial Tapes & Levels (211X) / Industrial Webber (149W)
Industrial GFS & Drill Rod (1120X) / Industrial Optical
Industrial Jigs & Recips (185XY) / Construction Tools (H612W)
Industrial Hack Saws (185XY) / Construction Tapes & Levels (211X)
Industrial Hole Saws (185HSX) / Construction GFS & Drill Rod (1120X)
Industrial Band Saws (185XB) / Construction All Saws (185XY & 185XB)
Force Measurement Systems (1811X)
Submitted by:
Date:

Rev 01242011

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