New Customer Form Israel

Sales Person

Date / Time

Your Name in Hebrew

Company Name in Hebrew

Text Input

Your Name in English

What is your identification document?

VAT Number

ID Number

Other

Which?

What is your identification number?

Address

Zip Code

Landline

Phone/Mobile

FAX

Contact Name

Contact Email

Email for sending electronic invoices

Customs Broker Name

What are your payment terms?

Credit

Cash

Currency to be charged

Shekel

Dollar

Euro

Multi

Please provide details of the currency to be charged

Who is in charge of payment

Customer

Customs Broker

Would you like to insure your cargo with us?

Yes

No

Do you need domestic transportation at Israel?

Yes

No

Submit Form