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COMPANY NAME: |
OWNER'S NAME: |
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BILLING ADDRESS: |
SHIPPING ADDRESS: |
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CITY: |
CITY: |
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STATE: |
STATE: |
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ZIP CODE: |
ZIP CODE: |
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PHONE: |
FAX: |
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DATE BUSINESS COMMENCED: |
ADDRESS: |
| CIRCLE ONE:
SOLE PROPRIETER PARTNERSHIP CORPORATION |
BUSINESS
WEBSITE ADDRESS: |
| BUSINESS TRADE REFERENCES: | SALES TAX ID#: |
|
COMPANY NAME: |
FAX # |
|
COMPANY NAME: |
FAX# |
|
COMPANY NAME: |
FAX# |
|
COMPANY NAME: |
FAX# |
|
OWNER NAME: (PLEASE PRINT) |
OWNER SIGNATURE: DATE: |
INSTRUCTIONS: PRINT, FILL OUT, AND FAX TO DAKOTA'S
KABIN AT 817-579-9518
WITH A COPY OF YOUR SALES TAX CERTIFICATE.
UPON APPROVAL YOUR
WHOLESALE CHECKOUT CODE AND INSTRUCTIONS WILL
BE FAXED TO YOU.