H. C. Schmieding produce company, llc (“hcs”) Information Page Please fill out this page and all attached pages, and email or fax back to us along with your W9, coi, and mc authority letter


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Schmieding Setup Packet for Carriers



 
H.C. SCHMIEDING PRODUCE COMPANY, LLC (“HCS”) 
Information Page 
Please fill out this page and all attached pages, and email or fax back to us 
along with your W9, COI, and MC Authority letter. Be sure to use a 
verifiable digital signature or physical signature on all documents. 
PO Box 369 
 
 
Toll Free: 800-643-3604 
trucks@schmieding.com
 
Springdale, AR 72765 
 
Fax: 479-725-6162
 
INTERNAL USE ONLY: 
Vendor Number:
__________________ 
Approved By: ______________________________ 
Date: ____________ 
 
Company 
Legal Name: 
_____________________________________ 
Fed ID or SS#: _________________________________ 
Address:
_____________________________________ 
MC #:_________________________________________ 
Address (cont): 
_____________________________________ 
US DOT #:_____________________________________ 
City: 
_____________________________________ 
State:
______________ Zip Code: ________ 
Contact Name: 
_____________________________________ 
Email:
_________________________________ 
Phone Number: 
____________________________ext ______ 
Fax Number: 
_________________________________ 
Remittance Address: 
_____________________________________ 
Remittance Address (cont): _____________________________________ 
City: 
_____________________________________ 
State:
______________ Zip Code: ________ 
Accounting Contact Name: _____________________________________ 
Email:
_________________________________ 
Phone Number: 
____________________________ext ______ 
Fax Number: 
_________________________________ 
Does your company use a Factoring Agent? Yes No
Name and Address of Factor________________________ 

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