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Authorized Reseller Application

General Information

Address(Required)
Address

Business Profile

Organizational Form:
Corporation(Required)
If Corporation:

Key Company Personnel

(Note: If multiple locations, please provide this information for each location)
President(Required)
Sales Manager
Accounting Manager
Purchasing Manager

Credit Line Request

Credit References

Address(Required)
Address(Required)
Address(Required)

Sales Tax Permit Information

Address(Required)
In compliance with Sales and Use Tax Laws, it is necessary that we have from all of our customers a signed resale certificate with their State Sales Tax Permit No., to show that the merchandise has been purchase for resale. The good faith of the seller will be questioned if he has knowledge of the facts which give rise to a reasonable inference that the purchaser of particular merchandise is not engaged in the business of selling that kind of merchandise. (If you have more than one resale number for multiple locations, please attach a resale card for each number.)
I hereby certify that I hold a Valid Seller's Permit No.
issued by the State of
and pursuant to the Sales and Use Tax Law of this State, that I am engaged in the business of selling
that the tangible personal property described herein which I shall purchase from Aqua View Inc., 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 the Sales and Tax Law to report and pay for the tax, measured by the purchase price of such property.
Description of property to be purchased for resale:
Name(Required)
MM slash DD slash YYYY

Authorization

The statements and information provided in this application and any attached documents are true and complete to the best of my knowledge. I also understand the following:
  • Information submitted in this application will be treated discreetly by Aqua View Inc.
  • Inaccurate and/or false information may be grounds for Aqua View Inc. to terminate any future contractual agreements
  • Aqua View Inc. may contact any person or business outlined in this application for the purpose of verifying the information submitted. By signing this document, I do hereby authorize any such person or business referenced herein to release any information via telephone, fax or mail to Aqua View Inc.
  • Applicant's signature attests to financial responsibility, ability and willingness to pay our invoices in accordance with the agreed upon terms.
Name(Required)
MM slash DD slash YYYY
This field is for validation purposes and should be left unchanged.