Wholesale and Corporate Account Set Up PLEASE COMPLETE THIS FORM TO SET UP YOUR NEW WHOLESALE OR CORPORATE RETAIL ACCOUNT! Company Name Purchaser's Tax ID Required for wholesale accounts only ABC License # Required for wholesale accounts only Primary Contact Name First Name Last Name Email Company Phone (###) ### #### Secondary Phone (###) ### #### Physical Address Address 1 Address 2 City State/Province Zip/Postal Code Country Billing Address Address 1 Address 2 City State/Province Zip/Postal Code Country Delivery Window / Receiving Hours Delivery Special Instructions Wholesale Payment Processing Is your company interested in using the Fintech Electronic Payment Program? Yes No N/A Corporate Payment Processing Is your company interested in using a corporate credit card to issue payment? Yes No N/A Thank you for submitting an account set up form! Sales will be in touch soon to discuss ordering options and next steps.
