Email *

Company *

Telephone *
( ) -
Fax
( ) -
Shipping address *

City *

State *

Zip Code *

Billing address *

City *

State *

Zip Code *


How long in business?

Is firm corporation? *
Yes   No
Accts Payable Contact


Owners Name *

Social Security #

Drivers License # *

Address *


Partners Name

Social Security #

Drivers License #

Address


Bank Reference

Name of Bank *

Telephone *
( ) -
Fax
( ) -
Address *

City *

State *

Zip Code *

Checking Account # *

Officer *


Trade Reference

Hunter Douglas: Acct #

Gulf Coast: Acct #

Lafayette: Acct #

Robert Allen: Acct #

Westgate Fabrics: Acct #

Timber Blinds: Acct #

Springs Window Fashions: Acct #

Seabrook: Acct #

Thybony, Inc.: Acct #

Kast Fabrics: Acct #

Kravet: Acct #

Other: Acct #


Terms

NET 30 from INVOICE DATE with approved credit.  A charge of 1-1/2% per month will be made on all past due accounts.  We reserve the right to change an account stauts from open to COD should the account become delinquent.

It is understood that all bad checks and overdue accounts will be turned over for collection and/or prosecuted.  Purchaser agrees to pay all costs of collection including court costs and reasonable attorney's fee in case suit or action is commenced to collect all or part of this account.

Limited Sales Tax Permit No.

Date (MM/DD/YYYY)

Company

Your Full Name

Your Job Title


Tax Resale Certificate

The undersigned holder of the Limited Sales Tax Permit listed above under authority of the Limited Sales, Excise and Use Tax Act, (TEX. TAX. GEN. ANN. art. 20.01 et seq.) claims the right to make a non-taxable purchase for resale of taxable items from:

Supplier's Name

Supplier's Address (City, State)


Taxable items purchased will be resold, rented or leased by purchaser within geographical limits of the United States, its territories or possessions in the normal course of business either in the form or condition in which purchased, or as an attachment to, or integral part of other tangible personal property.

Description of items to be purchased


I understand that I will be liable for payment of the Use Tax if I fail to comply with the applicable provisions of the Limited Sales, Excise and Use Tax act and Comptroller Rules regarding purchasing of taxable items for resale.

It is a misdemeanor to give Resale Certificate to teh seller for taxable items which I know at the time of purchase will be used in a manner other than that expressed in this certificate, and upon conviction I understand I may be fined up to $500 per offense.

AN OUT-OF-STATE RETAILER PURCHASING ITEMS FOR RESALE IN HIS HOME STATE MAY VALIDATE THE RESALE CERTIFICATE WITH THIS SALES TAX PERMIT NUMBER OR CERTIFICATE OF AUTHORITY ISSUED BY HIS HOME STATE

Name of Purchaser

Address (City, State, Zip)

Date (MM/DD/YYYY)