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Wholesale Application

Wholesale Application
Atlantic Pottery Supply, Inc.
400 Levy Rd.
Atlantic Beach, FL 32233
904-249-4499 Fax 904-339-0014
www.atlanticpotterysupply.com

For Atlantic Pottery Supply to properly process your application a copy of your current signed Florida Tax ID is required.

Please Print
Business Name:__________________________________________________________
Year Business was established:______________________________________________
Owner  Name(s)__________________________________________________________
Business Address:_________________________________________________________
City:_______________________________State:________________Zip:_____________ Shipping Address (if different from Business Address):
________________________________________________________________________
City:_______________________State:_______Zip:________E-
Business Phone:(____)_____________Home Phone:(____)_______________Fax:(____)____________
Email Addesss:____________________________________________
Website:__________________________________________________
Business License#____________________
Sales Tax Exempt#_________________________________
Names(s) of person(s) [maximum of 2] other than owner(s) authorized by applicant (business owner) to order and/or make purchases for this business. __________________________________________
__________________________________________

The undersigned certifies that all merchandise, good, and/or services purchased from Atlantic Pottery Supply, Inc. as of the above date are exempt from sales and use taxes for the reason indicated below.
Please check one:
________Resale of tangible personal property.
________To be incorporated as materials or part of other property to be produced for sale    by manufacturing, processing, or refining.
________Non-Profit Organization.  NPO#:_________________________________________________

This application/certificate shall be considered part of each order to be filled by Atlantic Pottery Supply for the above named business and is to continue in force until revised or revoked.
Signature of owner:___________________________________________

Please note: If your business plans on writing checks for your order Atlantic Pottery Supply needs a copy of your diver's license on file.
Name of Check Writer:________________________________________________
Copy Attached_____

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