Accusharp Knife and Tool Sharpener Dealer Application

ORGANIZATION
Organization Name	*		DBA or Trade Name
Billing Address	*		Shipping Address
Address Line 2			Address Line 2
City, State, Zip	*		City, State, Zip
Country	*		Country
Phone	*		Phone
Email	*		Confirm Email
OWNERS & PRINCIPALS
Owner's name	*		Title
Address	*		City, State, Zip			*
Owner's name			Title
Address			City, State, Zip
TYPE OF BUSINESS
Type of Business	Sole Proprietorship Partnership Corporation Other (LLC, etc.)
SSN or EIN	*		State Tax ID#			**
Years in Business	*	# of Employees	# of Salespeople			Inside Outside
Sales Entity			Sales Entity (if Other)
Warehouse Area (Sq Ft)			Geographical Areas Served
Describe your general lines of merchandise
REFERENCES
Bank Name	*			Phone
Address				City, State,Zip
Bank Officer				Years Associated

Trade Name 1	* (If none, put NA)			Trade Phone
Address				City, State, Zip
Contact/Title				Years Associated
Type Products Purchased					Fax

Trade Name 2	*			Trade Phone
Address				City, State, Zip
Contact/Title				Years Associated
Type Products Purchased					Fax
Comments

** Texas businesses: fax resale certificate to: 830-693-6394