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AIGNER INDEX, Inc.

218 MacArthur Avenue
New Windsor, NY 12553

P: (800) 242-3919
F: (845) 562-2638

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Material Handling Industry of America

Credit Application

NOTE: You must have a valid resale or tax Exemption Certificate Number to qualify for an account.

Company Name:

Address:

State:

City:

Zip:

Phone Number:

Fax:

Email:

Name:

Shipping Address:

City:

State:

Zip:

Type of Business:

Years in Operation:

President:

Home Phone:

Treasurer:

Secretary:

Address of Home Office:

City:

State:

Zip:

Three Suppliers (Open Accounts)

(1) Name:

Phone:

Fax:

City:

State:

Zip:

(2) Name:

Phone:

Fax:

City:

State:

Zip:

(3) Name:

Phone:

Fax:

City:

State:

Zip:

Banking Information

Bank:

Phone:

Fax:

Address:

City:

State:

Zip:

 

You must have a Valid Resale or Tax Exemption Certificate number. We will contact you for your certificate number.

Email us with your comments or call (800) 242-3919
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