LA SIESTA, Inc.

3325 NW 70th Ave

Miami, FL 33122
T: 786-401-1138
F: 786-401-1139

NEW CUSTOMER SETUP

General Customer Info
Customer Name:
Foreign Name/DBA:
Resale No:

Tax ID:

Sales Channel(s):

Store

Catalog

Number of Stores:

Chain Store

Wholesale

Type of Store:

Online Retailer

Other

Telephone 1:

Telephone 2:

Email:

Fax:

Website:

Customer Contact Persons

Primary:

Title:
Telephone 1:

Mobile:

E-Mail:

Fax:

Purchasing:

Title:
Telephone 1:

Mobile:

E-Mail:

Fax:

Telephone 1:

Mobile:

E-Mail:

Fax:

Telephone 1:

Mobile:

E-Mail:

Fax:

Telephone 1:

Mobile:

E-Mail:

Fax:

Accounting:

Shipping:

Other:

LA SIESTA, Inc.
3325 NW 70th Ave
Miami, FL 33122
T: 786-401-1138
F: 786-401-1139

Billing Address
Bill to Name:
Bill To Address:
City:

State:

Yes

Email Invoices:

No

ZIP:

Email To:

Shipping Address
Ship to Name:
Ship to Address:
City:

State:

Yes

Email Tracking Info:

No

ZIP:

Email To:

Ship to Name:
Ship to Address:
City:

State:

Yes

Email Tracking Info:

No

ZIP:

Email To:

NOTE: If you have more than two shipping locations please attach a separate sheet.

Yes

Mail Catalog(s):

No

Attention To:

Catalog Address:
City:

State:

ZIP:

Shipping Preferences
Third Party Carrier:

Okay to Ship Partial:

Third Party Account:

Yes

No

Note:

INTERNAL USE ONLY

Discount:

Drop Ship:

Credit Terms:

Drop Ship Fee:

Credit Limit:

Return Fee:

First contact via

Returns Allowed:

First contact date:

Allowance %:

Sales channel 1

Sales Rep:

Sales channel 2

Territory:

We assume partial is okay unless

customer instructs otherwise.
Customer pays freight on backordered
items.