Wholesale Registration – Replacement For R22

Email Address Password Confirm Password First Name Last Name Address Line 1 Address Line 2 Company Name Suburb/City State/Province Zip/Postcode Country Phone:

Company Details

Do you currently sell online?

Yes

Business Type

State Resale Tax ID# (if applicable)

We are required by the IRS to get a Taxpayer Identification Number from you. Please fill your Employer Identification Number (EIN) below.

Tax Exemption Form

Under penalties of perjury, I certify that:

1. The number shown is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and
2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject o backup withholding. (You must cross out this item if you have been notified by the IRS that you are currently subject to backup witholding because of underreporting interest or dividends on your tax return.)

I agree to the above terms and conditions

Tax Exemption