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Buyer Profile Form

Business Information

Business Name*

Legal Entity Type*

Business Address*

Federal Tax ID (EIN) or SSN*

Upload EIN/SSN Document*

Select File

Upload Reseller's License*

Select File

State Sales Tax Permit or Reseller's License #*

Years in Business*

Brief Business Description*

Contact Details

Primary Contact Name*

Phone Number *​

Billing Address*

Title*

Email Address*

Shipping Address (if different)

Product / Market Information

Types of Products You Plan to Purchase*

Target Market or Customer Base*

Estimated Order Volumes or Purchase Amounts*

Retail Locations or Sales Channels*

Upload Related Sales Channel Photos

Select File

Please fill in all fields.

Data Submitted Successfully!

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