molly mutt wholesale/credit application

(1) new customer application, general information (required for all applicants)

1. applicant legal name
2. contact email address
3. company name or dba
4. business address
5. city, state, zip
6. phone
7. fax

(1a) business type

1. sole proprietorship
2. partnership
3. corporation
4. in business since:
5. resale #:
6. federal tax ID:

(2a) owners, partners, corporate officers, guarantors

1. name
2. social security number
3. title
4. phone
5. driver's license or state ID
6. home address
7. city, state, zip

(2b) credit references

1. firm name
2. phone
3. fax
4. address
5. city, state, zip

(2c) bank information

1. bank name
2. phone
3. fax
4. address
5. city, state, zip
6. acct #

(2d) credit information

1. total approximate sales per year ($)
2. estimated yearly purchases ($)
3. minimum initial credit line requested

1. sales permit no.
2. sales type
I hereby certify that I hold valid seller's permit no. issued pursuant to the sales and use tax law; that I am engaged in the business of selling the above referenced item types. I certify that the tangible personal property described herein which I shall purchase from molly mutt llc will be resold by me in the form of tangible personal property; provided, however, that in the event any of such property is used for any purpose other than retention, demonstration or display while holding it for sale in the regular course of business, it is understood that i am required by Sales and Use Tax Law to report and pay tax, measured by the purchase price of such property. Description of property is to be purchased: dog duvets and stuff sacks; pet decor products.
3. Date:
4. Applicant's Name