Your Business 
right to be informed

Please include all of the following information to ensure accurate notification and timely processing.

Date:


mm-dd-yyy

Company Name:

Name on CMP Bill:
Address:
City:
State and ZIP Code:  ZIP Code:
Account Number:


XXX-XXXXXXX-XXX

*Add Additional account numbers in the "Other Comments" field below.

Contact Person:
Phone Number:

  Ext.
Add additional phone numbers in the "Other Comments" field below.

Fax:
E-mail Address:

*Your 4-digit
Standard Industrial
Classification SIC Code(s):
*Enter additional SIC codes in the "Other Comments" field below.
Other Comments:

Please check all classifications that apply using the descriptions below:

            

 

Manufacturer: Do you manufacture a product? If so, what is the primary product you produce? (Please be specific, examples: plastic clothespins, wood kitchen cabinets, corrugated boxes, wood household furniture (upholstered), wood household furniture (except upholstered), etc.)

 

Please list raw material used to produce product (example: wood, plastic, paper, metal, etc.):

 

 

Service: Do you provide specialized service to businesses or the public? If so, what is the primary service you provide? (Please be specific, examples: fast-food restaurant, high school, warehousing or storage, utility services, trucking, computer programming, insurance agent, real estate management, etc.)

 

 

Retailer: Do you sell products to the ultimate consumer? If so, what is the primary product you sell? (Please be specific, examples: men or women's clothing, gift or novelty items, grocery items, automobiles, books, etc.)

 

 

Wholesaler: Do you sell products or equipment to companies for resale? If so, what primary type of products or equipment? (Please be specific, examples: food items, furniture, office supplies, lumber, fuels, specialized equipment, jewelry, etc.)