Wholesale Application |
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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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