In Southwest MO
Better Business Bureau
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BBB serving Southwest Missouri Business Profile

In compliance with BBB Privacy Policy, BBB serving Southwest Missouri will use the personal information you provide below only for the purposes for which you have given permission.

Thank you for your interest in Better Business Bureau. This form will give us basic information about your company to enable us to create a file in our database. This is not an application for accreditation. You may get more information about becoming an Accredited Business by visiting our web site.

* Required Fields

Business Identification

* Business Name (Main, Corporate or Legal)
Other Business Names(DBA)
* Primary Telephone
Primary Fax
* Primary Address
* City
* State
* Zip
Web Address
Public Email Address
Mailing Address (if different)
City
State
Zip
Additonal locations, phone, fax and email addresses
* 1. Business Type:
Other:
Date and State Filed:
Number of Locations
* 2. Nature of Business:
Other:
3. To Whom Do You Sell?
Other:
4. Type of Local Facility:
Other:
5. Scope of Business/Marketing:
6. Gross Annual Revenue (for BBB internal use only):
7. Number of Customers annually:
7. Number of Employees/Staff/Personnel
(for BBB internal use only)
8. Date Business Established
Originally:
In Southwest Missouri:
Under New Ownership:
9. Length of Time at This Location
10. Describe Products or Services Offered
Business Category(ies) you are listed under in the Yellow Pages:





 

Licensing Information

Professional Licensing

Name of Licensing Authority
License Number
Date Issued
Date Expires

State Licensing

Name of Licensing Authority
License Number
Date Issued
Date Expires

City/Local Licensing

Name of Licensing Authority
License Number
Date Issued
Date Expires

Other Licensing

Name of Licensing Authority
License Number
Date Issued
Date Expires
 

Advertising or Marketing Details
(check all that are applicable)

Local Advertising
National Advertising
Radio Advertising
Television
Newspaper
Direct Mail
Other
   

Give Names, Titles and Addresses and Phone Numbers of Officers/Owners

Name
Title
Address
City
State
Phone
Email
 
Name
Title
Address
City
State
Phone
Email
 
Name
Title
Address
City
State
Phone
Email
 
Name
Title
Address
City
State
Phone
Email
 

Give Business History for the Past 5 Years for Above Individuals

1.
2.
3.
4.
 

References
If you are interested in accreditation with BBB, please fill out the following references (if applicable)

Local Bank Reference
Name
Telephone
Address
City
State
 
Business Reference
Name
Telephone
Address
City
State
 
Customer Reference
Name
Telephone
Address
City
State
 

Please Provide the Name of a Contact Person that the BBB can Call for Additional Information

* Contact Name
* Title
* Work Phone
Fax
Email

Please Provide the Name of a
Contact Person who handles complaints for your business

Complaint Contact Name
Title
Work Phone
Fax
Email
How do you prefer to recieve complaints?
Email:
Fax:
Mail:
 

Information Provided By

* Contact Name
* Title
* Work Phone
Fax
 
* Please enter the text you see in the image:
 
Accreditation in BBB is by invitation
Better Business Bureau - serving Southwest Missouri
2754 S. Campbell Avenue
Springfield MO 65807