Business Background Information Request

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 Reliability Report. This is not a BBB Accredited Business Application.

Our use of your personal information will be consistent with our BBB Privacy Policy.

(items in red below are required)

 
Business Name (please list in order best known to the public)
Business Name #1:
Business Name #2:
Business Name #3:
 

Business Address
Address:
City:
State:
Zip Code:
 

Mailing Address
Address:
City:
State:
Zip Code:
 
Public Phone:
Private Phone: (for BBB internal use only)
Fax::
Web Address:
Public Email:
 
 

Please list three executives/principals of the firm
Name:
Title:
E-mail:
 
Name:
Title:
E-mail:
 
Name:
Title:
E-mail:
 
Complaint Handler Name:
Title:
E-mail :
Fax:
Complaints should be: Mailed
Faxed
Emailed
   
 
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Business Information

Number of employees:   
Established:   
Incorporated:   
Type of business entity: Corporation
Partnership
Sole Proprietorship
Franchisee
LTD
LLC
Is company a franchise? Yes No
If yes, where is franchise headquartered?
   
  Click on entry box to select from Type of Business Listing   

Type of business:
As in yellow pages

Additional type of business #2:
Additional type of business #3:
Additional type of business #4:
Additional type of business #5:
Additional type of business #6:
   
  Brief factual description of products and/or services

 
 
Additional public telephone number(s)
in Eastern Massachusetts, Maine and Vermont
 
   
 

Additional locations in
Eastern Massachusetts (zip codes 01700-02799), Maine & Vermont
Please list address, city, state, zip code
and if at a mall the mall name.
 
   
  Licensing Information
Please list license number, type, issuing agency
Please specify if it is a personal or company license.
 
   
Refund, Exchange
and Return Policy:
 

Submitted by

Your Name:
Your Title:

Reference # (if known):

 B
The reference number can be found at the bottom of the cover letter and starts with a B. It can also be found on the back of the Business Background Information Request Form, in the gray area. (BBIR#)
 

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