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The Better Business Bureau
Phone: (540) 342-3455 31 W. Campbell Ave.
Toll Free: (800) 533-5501 Roanoke, VA 24011-1301
Fax: (540) 345-2289 Web Address: www.roanoke.bbb.org
E-Mail: info@roanoke.bbb.org
 

BUSINESS QUESTIONNAIRE

*Indicates required field
*
Firm Name:
(Corporate or Legal Name)
Contact Name:*
Address:*
City:*
State:*
Zip Code:*
Mailing Address:
(If different from above)
Telephone:*
Fax:
Email:
Website URL (Address): http://

List Other Locations, D.B.A.'s,
and Additional Information Here:

This Company is:*

 New Firm   Re-Organization  
Successor to:
Nature of Organization:* Corporation  Partnership      
Sole Proprietorship
If Incorporated:
Date of Incorporation:
State of Incorporation:

Date Company Established:*
Date Local Operations Began:*
Business License Number:*
Business License Received From:*
 City
County
Number of Local Employess:* Full-Time Employees:
Other Required Licensing:
(State Contractors License, etc.)
Nature of Business:*
Manufacturing Wholesale/Distributor
Financial Professional
Retail Other
Is This Company A Franchise:* Yes    Division of:
No
Product or Service Offered:*
*
Principal Officers, Directors,
Partners, or Proprietor:


Name & Title:
*
Identify Person Responsible
For Complaints / Billing:

Describe Facility Here:*
Plant Warehouse
Shop Store
Service Professional Office
Business/Sales Office
References:*
Local Bank:

Local Supplier:

Local Customer:

Advertising Agency:
Media Used:*
(Check all that apply)
TV Radio
Magazine Outdoor
Newspaper Direct Mail
Other Internet
*
Has Any Legal Action Taken Place Against You Or Your Busines By Any Governmental Organization Within The Past Three Years:

Yes   No
Comments:

Please Note: This is not an application for membership in the BBB. The fact that you have furnished this information does not imply endorsement of your firm or product, nor does it authorize use of the BBB as a printed reference.
Name:*
Title:*
Date:*