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Fields marked with an * are required
Legal Entity
*
DBA (If different than organization above)
Shop Phone Number
*
Shop Website
Federal Tax ID
*
SSN of Owner (owner is ocnsidered 51% or more of Legal Entity)
*
Owner's Legal Name
*
Owner's Phone Number
*
Owner's Email Address
*
Buyer's Name, Number, and Email Address
Only needed if different than Owner's information above.
Billing Street Address
*
Billing City
*
Shipping Street Address
Shipping City
Shipping State
If different from billing address
Shipping Zipcode
Country
How long have you been in business?
*
Less than 1 year
12-24 months
25-36 months
37-48 months
49-60 months
More than 5 years
Tax Resale Certificate Number
*
Upload Copy of Resale Certificate.
Upload Business License or Tax ID.
Credit References
*
Please list
three
business references only, and please do not list Factors, Benartex, United Notions, Hoffman, or Martingale.
Shipping/Billing Instructions
Please list any specific instructions you'd like for us to follow when shipping to your location, such as weight restrictions, or always use COD, for example.
Would you like a copy of this application to be sent to you for your files?
Yes
No
Custom Text
*
Yes
No
By opening a wholesale account with Lumin Fabrics, you agree to the following
terms and conditions
.
Shop Phone Number
*
Separate email addresses with a comma.
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