Dealer | New Customer Application

Company Name*

Main Contact*

First Last

Phone*

Email*

Website*

Web address must be prefixed by http:// or https://

Social Media Links

Facebook, Instagram, Youtube, Twitter, etc

Shipping Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Billing Address*

Same as Shipping Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

State Tax ID #

Federal Tax ID #

Submit a copy of your state resale tax certificate*

Max. file size: 2 MB.

Upload a picture, scan, or digital copy of your state resale permit that shows business name and tax ID #.

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Email

This field is for validation purposes and should be left unchanged.