Processors & Buyers of Gold Scrap, Silver Scrap Platinum, Palladium, Rhodium & other PGMs
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Smelters and Assayers

US Patriot Act Form
Date: M/D/YYYY
1.
Customer Name:
 
Type (check one):
Individual
Corporation
Partnership
LLC
Other
2.
DBAs, Trading Names:
3.
Address:
 
City:
 
State:
 
Zip
 
Telephone:
4.
Tax I.D., or S.S.# :
5.
Description of your business (check the appropiate)
   
Pawn Broker
Jewelry Retail
Trade Shop
Jeweler
Watch Repair
Precious Metals Dealer
Other Explain ↓
 
 
Email:

American Precious Metals Houston Web Design Houston

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