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)__________________________________________________________ 

Owners Address:_________________________________________________________

City:_______________________________State:________________Zip:_____________

 

 

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:___________________________________________