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Register Your Business

Register Your Business
Your cooperation is appreciated in helping BBB to provide accurate up-to-date information to your prospective customers, suppliers, financial institutions and others who inquire about your business. This form will give us basic information about your business to enable us to create a BBB Business Review. This is not a BBB Accredited Business Application. Our use of your personal information will be consistent with our BBB Privacy Policy.  
Business Name (please list in order best known to the public)
 
Business Name #1:  
Business Name #2:  
Business Name #3:  
Business Name #4:  
Business Name #5:  
Business Address
 
Business Address:  
Business City:  
Business State:  
Business Zip Code:  
If at a Mall, the Name of the Mall:  
Mailing Address
 
Mailing Address:  
Mailing City:  
Mailing State:  
Mailing Zip Code:  
Public Phone:  
Additional Public Phone:  
Additional Public Phone:  
Toll-Free Phone:  
(For BBB Internal Use Only) Private Phone:  
Fax:  
Web Address:  
Web Address:  
Web Address:  
Public Email:  
Sales Email:  
Customer Service Email:  
Technical Support Email:  
Please list three executives/principals of the business  
Primary Contact  
Contact Salutation:  
Contact Name:  
Contact Title:  
Contact Email Address:  
Contact Phone Number:  
Contact Fax:  
Contact Cell Phone Number:  
Additional Contact  
Salutation:  
Contact Name:  
Contact Title:  
Contact Email Address:  
Contact Phone Number:  
Contact Fax:  
Contact Cell Phone Number:  
Additional Contact  
Contact Salutation:  
Contact Name:  
Contact Title:  
Contact Email Address:  
Contact Phone Number:  
Contact Fax Number:  
Contact Cell Phone Number:  
Send Any Complaints to:  
Complaint Handler Salutation:  
Complaint Handler Name:  
Complaint Handler Title:  
Complaint Handler E-mail:  
Complaint Handler Phone Number:  
Complaint Handler Fax Number:  
Complaints Should Be:

 
Complaint Hander Cell Phone Number:  
Business Information  
This is a number, (Example 5).
Please enter the number of full time employees.
2 part time employees = 1 full time employee.  
Number of Employees:  
Date Established:
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Date Incorporated:
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Type of business Entity:




 
"Customers" are those persons who fall into one or more of the following categories:
1. Consumers who purchased a product or service from the business.
2. Consumers who entered into a contractual relationship with the business.
3. Consumers who directly received services from the business, or were contacted by the business with a demand for payment of money owed, ONLY IF the BBB generally accepts complaints from those consumers against this type of business.

Note: Consumers = people or businesses  
(BBB Internal Use Only) Number of Active Customers:





 
(BBB Internal Use Only) Gross Annual Revenue:





 
Business Scope:  
Hours of Operation  
Employer Identification Number (EIN):  
Monday:  
Tuesday:  
Wednesday:  
Thursday:  
Friday:  
Saturday:  
Sunday:  
Payment Methods Accepted:  
Cash  
Personal Check  
Business Check  
Cashiers Check  
Money Order  
MasterCard  
Visa  
American Express  
Discover  
PayPal  
Debit Card  
Automatic Bank Withdrawl  
Online  
Financing  
Corporate Headquarters City:  
Corporate Headquarters State:  
Is business a franchise?:
 
If yes, where is franchise headquartered?:  
Type of Business: Select a TOB  
Type of Business: Select a TOB  
Type of Business: Select a TOB  
Type of Business: Select a TOB  
Brief Factual Description of Products and/or Services:  
Brands You Sell:  
Products You Sell:  
Additional Locations (Address, City, State, Zip Code, Phone, Fax, If at a Mall the Mall Name):  
Please list: -license number -type -issuing agency -state issued -date issued -expiration date -Please specify if it is a personal or business license  
Licensing Information:  
Refund, Exchange and Return Policy:  
Notes or Comments to BBB:  
I am authorized to submit this information on behalf of the business and all the information submitted is truthful and accurate.  
Submitted By  
Your Name:  
Your Title:  
The reference ID number can be found at the bottom of the letter/email.  
Reference # (if known):