New Customer Registration — Shipica: A Warehousing & Fulfillment Services

Company Name

Main Contact Name

First Name

Last Name

Amazon Seller Name

Company Tax ID or Individual SSN

Tax ID from Governing Body or SSN

Main Contact Phone Number

Main Contact Email

Company Billing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Company Shipping Address (if different than billing)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Website (if any)

http://