* Required
Fields
Business Identification
* Business Name (Main,
Corporate or Legal)
Other Business Names(DBA)
* Primary Telephone
Primary Fax
* Primary Address
* City
* State
* Zip
Web Address
Public Email Address
Mailing Address (if different)
City
State
Zip
Additonal locations, phone, fax and email addresses
* 1.
Business Type :
sole proprietorship
partnership
corporation
franchise
other
Other:
Date and State Filed:
Number of Locations
1
2-4
5-9
10-99
100 or more
* 2.
Nature of Business :
manufacturing
distributor
professional
retail sales/service
commercial sales/service
other
Other:
3. To Whom Do You Sell?
retail
wholesale
distributor
other
Other:
4. Type of Local Facility:
plant
warehouse
sales office
retail sales
location service/repair facility
other
Other:
5. Scope of Business/Marketing:
Local/Central Ohio
Regional/Statewide in Ohio
Multi-state
Nationwide
International
Internet
Seasonal/Mobile
6. Number of Active Customers (for BBB
internal use only):
1 to 499
500 to 49,999
50,000 to 99,999
100,000 to 999,999
1,000,000 or more
7. Gross Annual Revenue (for BBB internal
use only):
$1 to $499
$500 to $49,999
$50,000 to $99,999
$100,000 to $999,999
$1,000,000 to $9,999,999
$10,000,000 to $49,999,999
$50,000,000 or more
8. Number of Employees/Fulltime Equivalent
Exclude Independent Contractors
(for BBB internal use only)
1-9
10-49
50-499
500-4999
5000 or more
9. Date Business Established
10. Length of Time at This Location
11. Describe Products or Services Offered
Note : If product or service is being
franchised, please mail a copy of the contract and a description of
the marketing plan to the address below, or upload the files here
Licensing or Business Registration (if Licensing
is Required)
Name of Licensing Authority
License Number
Date Issued
Date Expires
State Issued
Additional Information
Advertising or Marketing Details
(check all that are applicable)
Other
Give Names, Titles and Addresses of Officers/Owners
Name
Title
Address
City
State
Name
Title
Address
City
State
Name
Title
Address
City
State
Name
Title
Address
City
State
Give Business History for the Past 5 Years for
Above Individuals
1.
2.
3.
4.
References
If you are interested in accreditation with BBB, please fill out the
following references (if applicable)
Local Bank Reference
Name
Telephone
Address
City
State
Business Reference
Name
Telephone
Address
City
State
Customer Reference
Name
Telephone
Address
City
State
Please Provide the Name of a Contact Person that
the BBB can Call for Additional Information
* Contact Name
* Title
* Work Phone
Fax
Email
Please Provide the Name of a
Contact Person who handles complaints for your business
Complaint Contact Name
Title
Work Phone
Fax
Email
Information Provided By
* Contact Name
* Title
* Work Phone
Fax
Accreditation in BBB is by invitation
Better Business Bureau -
Serving Central Ohio
1169 Dublin Rd.
Columbus OH 43215