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Jeffers, Inc.: Application Does Not Establish A Credit Account!

This document is a wholesale application for Jeffers, Inc. It requests information such as the applicant's company name, contact details, business type, tax identification, and preferred catalogues. The applicant must provide documentation like a sales tax, EIN, or retail license number to be approved for wholesale status. It informs that back orders may be placed if an item is out of stock and to return the completed form to specific contacts.

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Son Nguyen
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204 views1 page

Jeffers, Inc.: Application Does Not Establish A Credit Account!

This document is a wholesale application for Jeffers, Inc. It requests information such as the applicant's company name, contact details, business type, tax identification, and preferred catalogues. The applicant must provide documentation like a sales tax, EIN, or retail license number to be approved for wholesale status. It informs that back orders may be placed if an item is out of stock and to return the completed form to specific contacts.

Uploaded by

Son Nguyen
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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            Customer #____________________   

     

(800) 533­3377  Jeffers, Inc. 
   ​        P.O. Box 100 
 Fax (334) 793­5179        ​
WHOLESALE APPLICATION  Dothan, Alabama 36302 
  
APPLICATION DOES NOT ESTABLISH A CREDIT ACCOUNT! 
  
Company Name: _____________________________________________________________ 
  
Contact Name: ______________________________________________________________ 
  
Mailing Address:  ____________________________________________________________ 
  
City______________________________ State_________ Zip_________________ 
  
  
Ship­To Address:  ____________________________________________________________ 
  
City_______________________________ State_________  Zip________________ 
  
Phone: (______) ______­_______________  Fax: (______)  ______­______________ 
  
E­mail Address:  _____________________________________________________________ 
  
Current Supplier(s) ​
____________________________________________________________ 
  
TYPE OF BUSINESS

_____ Pet Retail  _____Feed Store  _____Training 

_____Grooming  _____Tack Shop  _____Kennel/Boarding 

_____Veterinarian  _____Website sales  _____Other 


  
Back Orders Accepted?   _____ Yes     _____No 
(In the event we are out of stock, should we place the order to be shipped when it comes in?) 
  
Which catalog(s) would you like to receive? Equine _______  Pet _______  Livestock ________ 
  
SALES TAX, EIN or RETAIL LICENSE #___________________________  
YOU MUST ATTACH A COPY OF SALES TAX, EIN or RETAIL LICENSE. 
PLEASE ATTACH A NON­PROFIT LETTER (if applicable). 
Wholesale Status WILL NOT be approved without proper documentation! 
  
Signature:  _____________________________________ Print Name_____________________________________ 
  
Preferred method of contact:       E­mail_____   Telephone_____   Fax_____ 

Please Return To: 
Stacey Birge ​  ​
(ext 347)​  ​
or e­mail​[email protected]  
Tamera Montgomery ​  ​
(ext 339)​  ​
or e­mail​[email protected] 
 
Please don’t forget to register online with your e­mail address & password to expedite the registration  process. 

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