NA LGM - New Account Form

LABEL & GRAPHIC MATERIALS NORTH AMERICA
NEW ACCOUNT FORM

Please fill out this form and our team will connect with you to review your information and determine how we can best service your account.

Company Name*

Ship to Street*


Ship to City*	Ship to State/Province*


Ship to Postal Code*	Ship to Country*

Ship to Telephone*	Ship to Fax

Bill to Street*


Bill to City*	Bill to State/Province*


Bill to Postal Code*	Bill to Country*

Bill to Telephone	Bill to Fax

Company Type*

Corporation (List parent firm name, if applicable)

Partnership

Proprietorship

Division Of

Subsidiary Of

When was the Company Established? (Year)*

Nature of Purchasers Business*

Retailer

Wholesaler

Manufacturer

Distributor

Merchant

Contractor

Co-Packer

End User

Certifications (UL/ISO)

Names of Principles (Owners/Active Partners with Titles)*

Main Purchasing Contact's Name*

Main Purchasing Contact's Email***

(** Email address is used to set-up your account to receive Order Acknowledgements via email and to give you access to averydennison.com online services)

Accounts Payable Contact's Name*

Accounts Payable Contact's Email***

(** Invoices are transmitted electronically. Email address information will be used to set-up your account to receive invoices via email)

Claim Acknowledgment Contact's Name*

Claim Acknowledgement Contact's Email*

Claim Updates Contact's Name*

Claim Updates Contact's Email*

US Accounts ONLY:

Federal Tax ID

Is Customer Exempt from Sales Tax

If yes, please attach properly executed Sales Tax Exemption Certificate for each Ship To State, or complete the Multi-Jurisdiction Uniform Sales & Use Tax Exemption/Resale Form. If attaching more than 1 document, please compress/zip the files into 1 file and attach below.

Canadian Accounts ONLY

GST #	PST #

Major Suppliers:

Company Name #1	Company Name #2

Contact	Contact

Telephone	Telephone

Others (Please explain)

Annual total material purchases?

Purchase from other Avery Dennison divisions? If so, which?

Purchase Preference

PS Roll Stock

Non PS Roll Stock

Shrink Roll Stock

Your manufacturing capabilities

NF Digital

WF Digital

Flexo

Screen

Off-set

Gravure

Other

Press Types

Social Media Platforms:

Facebook

Twitter

Instagram

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