Please fill out the form below to set up a full-access account with Hy-Tek Material Handling, Inc. We have a 50,000-item catalog in addition to the products listed on our web site, and you can order that and other literature on our "Contact Us" page, or call us at 800-837-1217 for more information.

New Customer Application Form   Today's Date // Company Name Address City State Zip Telephone # - - Contact Name Accts Payable Contact Accts Payable Phone # -- Accts Payable Fax # -- Business References: Name-Address-City/State/Zip - Contact - Phone 1 > Fax# - - 2 > Fax# - - 3 > Fax# - -   Bank Reference Name: Branch Address Bank Phone # Bank Contact Account #   I hereby authorize release of any credit information from the references stated above by pressing the submit button below. Note: If some or all of your purchases will be exempt from sales tax, please forward an exemption certificate to our columbus address listed below or fax it to (614)497-2321 Attn: Accts. Receivable — Thank You 2222 Port Road Columbus, OH 43217   Credit Card Account Holder's Name: Credit Card Type: VisaMasterCardDiscoverAmerican Express Credit Card Number: Exp. Date: January Febrary March April May June July August September October November December 2005 2006 2007 200820092010 SIC Code D & B Number