Sales Reps and Distributors Wanted Business Name* Business Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Resale Number or Certificate* Owner/Rep Name* First Last Phone Number*Email* How Long in Business* How Many Locations do you ownTax Exempt StatusPlease sign a copy of your California Resale Certificate for Sales Tax since it is required for Tax Exempt Status.Tax Exempt Customers*SelectTax ExemptIf your company is eligible for Tax Exempt Status, please select "Tax Exempt" when choosing a tax region from the drop down menu of locations. Please enter your Tax Resale Number in box as prompted. No tax will be added to your order from there on.Appropriate DocumentationAfter we receive your order, we will confirm that your company has provided us with a current copy of your signed California Resale Certificate. Alternatively, you can mail us a copy to: Souvenix, Inc. P O Box 251444 Los Angeles, Ca 90025 Thank you.Additional Comments*
