InstructionsNew York • October 11th, 2016
Jurisdiction FiledOctober 11th, 2016Company Full Legal Name (“Dealer”): Street Address (no PO boxes): City: State: Zip: Phone: ( ) Fax: ( ) Union Card Certification (check one): Yes No Email: Website URL: Company Federal Tax ID Number (9 digits): HVACpartners ID #: HVACpartners ID #s for Additional Branch Location(s) if applicable#: