0_New+Customer+Registration+form_TDIR+5233.pdf
PDF 239 KB Posted
- Contract number
- 489-VOIA
- Issued by
- North Dakota
About this file
This document is a New Customer Information form (TDIR 5233), designed for capturing details of a new customer or vendor. The form is structured to collect essential organizational and contact information, including the name of the organization as shown on a W-9, full address, main contact person details, and invoice recipient information.
The form includes fields for tax exemption status, with an option to indicate whether the organization is tax-exempt and a request to provide a Tax Exempt Certificate if applicable. It requires an electronic or typed signature and date. The form is intended to be completed electronically, with instructions to email the completed document to a vendor contact. No specific goods, services, pricing terms, or contract details are present in this document, as it appears to be a standardized information collection form.
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Other files
| File | Type | Posted |
|---|---|---|
| 489_State+Contract+Summary.docx | DOCX document | |
| DIR-CPO-5233+Appendix+C+Pricing+Index.pdf | ||
| DIR-CPO-5233+Contract.pdf | ||
| Translation+Services+-+PA+for+Signature.pdf |
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Text version
Name
Phone #
Name
Address
Phone #
Yes
No
NEW Customer info - TDIR 5233
Address, City, State, Zipcode
Main Contact person
Send invoice to
Name of organization as shown on W-9 If you're not an organization, please add your name
If Yes, please send Tax Exempt Certificate.Tax Exempt?
Date
Electronic or Typed Signature
This form is editable; please type the information requested.
Email this completed document to the vendor contact.
Sheet1
| Name of organization: |
| Address, City, State, Zipcode: |
| Main Contact Name: |
| Main Contact Email: |
| Main Contact Phone #: |
| Send invoice to Name: |
| Send invoice to Address: |
| Send invoice to Email: |
| Send invoice to Phone #: |
| Tax Exempt Yes: Off |
| Tax Exempt No: Off |
| Date: |
| Signature: |
File details come from the government source that posted it. Updated .