"*" indicates required fields NameThis field is for validation purposes and should be left unchanged.Please fill out the form below and our Credit Department will contact you when form is received for your card informationCompany Name:*PLI Account Number:*Billing Address:*City:*State:*Zip:*Phone:*Fax:Email Address:*Persons Authorized To Purchase Using This Card:Person 1*Person 2Person 3By Signing This Form, I authorize Peterman Lumber Inc. to charge my credit card for purchase and agree to pay all charges according to the card issuer agreement.Signature*CAPTCHA Δ Terms and Conditions