Customer Information Form

Job Name:

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If Other is selected as Job type, what is it?:

Job Description:

What is your budget for this project?:

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Job Address:

City, ST Zip:

Property Access Code / Combo / Key / Lock Box / Other:

Point of Contact:

Email:

Phone:

Have you discussed this project with anyone at Burnett Customs? If so, who?

Customer Name:

Address:

City, State Zip:

Email:

Phone:

Alternate Contact Name:

Alternate Phone:

Is this Job Taxable?

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Yes

Tax Exempt Number:
(Include Picture)

File / Image upload

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