Reseller Application Form

Reseller Application
To apply for resale or wholesale status please complete all questions.
Name*
First NameLast Name
Address*
Street Address
Street Address Line 2
CityState / Province
Postal / Zip CodeCountry
E-mail*
Phone Number*
Area CodePhone Number
Cell Number
Area CodePhone Number
Website
Account Type*
Reseller AccountWholesale Account
Estimated Monthly Sales (quantity)*
In order to make tax-exempt purchases, we require a tax ID and reseller certificate from accounts based in New York State. Please provide these now to make tax-exempt purchases immediately upon account approval.
Sales Tax ID
Reseller Certificate
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