Wholesale Application

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Wholesale...

Thank you for your interest in establishing a wholesale account with Red Belly Honey.

We receive numerous requests wanting to purchase products at wholesale prices; therefore, in order to protect the integrity of our valued customers, we have established the following parameters for opening new accounts.

Please confirm that your business has ALL of the following before proceeding with the application.

Wholesale Application

"*" indicates required fields

Step 1 of 8

Confirmation*

I confirm my business meets all the below listed requirements.

By checking the above box, I am confirming that my business has the following:
1. A storefront or commercial location not inside a home, with a dedicated business phone number
2. A tax ID number or federal ID number
3. A business checking account with the ability to send ACH payments—we do not accept personal checks
4. A business type within this list
5. The ability to commit to minimum yearly purchase requirements of $1,000

Business Information

Business Name*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Business website*

How did you hear about the program?*

Business Contact Information

Please enter contact information for the account.

Name

First Last

Title

Email*

Phone*

Business Details

Business Summary*

Business EIN number*

How Do You Sell Products?*

Online

In-store

Other

Other Sales Outlet

What is your primary business focus?*

Physical store

E-commerce website

Does your physical store have more than one location?

Yes

Physical Store Type

Please select the store type that best describes your business

Is the address of the company headquarters the same as the business address?*

Yes

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Number of stores*

Number of Employees*

Banking Information

Please enter your banking information below. Payment terms: ACH upon order.

Bank Name*

Account Name*

Routing Number*

Account Number*

Confirm Account Number*

Billing and Shipping Address

Is the billing address the same as the business address?

Yes

Business name*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Is the shipping address same as the billing address?

Yes

Business Name*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Authorized Buyers

These are the ONLY people that we can give information to, or accept orders from on your account. This is for your protection.

Authorized name 1*

Authorized name 2

Authorized name 3

Authorized name 4

Personal Guarantee

I (We),

Company Name*

and Individual Name

First Last

Certify and Agree*

I (We) certify and agree to the information in this document

I (We), (Company Name) and (Individual Name) certify that the information in this application is correct. I agree to notify Eat Your Greens LLC if any change of ownership occurs or if any other major change occurs in the way I conduct my business. I have printed a copy of this document and I understand its contents.
The undersigned, being an owner or stockholder of the above business, hereby agrees to pay any indebtedness by this business to Eat Your Greens LLC from whom this business may purchase merchandise in the future. The undersigned also agrees to pay all attorney fees, court costs, collection costs, and all other expenses which may be incurred in collecting past due balances and insufficient funds check(s), as permitted by law.

Signature 1*

Check to Certify Signature*

I confirm the name in the previous field is my signature.

Print Name

First Last

Signature 2

Check to Certify Signature

I confirm the name in the previous field is my signature.

Print Name

First Last

Blanket Certificate of Exemption

(Sales Tax Form) **This must be filled out or your application will not be processed**

Date

Sales Tax Form

The undersigned hereby certifies that the articles of tangible property purchased from Eat Your Greens LLC after the above listed date shall be purchased for: Purchaser must state statutory reason for claiming exemption or exception:

Resale in the form in which the same is, or is to be, received

Manufacturing

Other

This certificate shall continue in force until revoked and shall be considered a part of each order given to the above named vendor unless the order specifies otherwise.

Signature*

Check to Certify Signature*

I confirm the name in the previous field is my signature.

Title

Date*

Company Name*

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Wholesale Application

Wholesale Application

Business Information

Business Contact Information

Business Details

Banking Information

Billing and Shipping Address

Authorized Buyers

Personal Guarantee

I (We),

Blanket Certificate of Exemption

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