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Business Type * Choose one Distributor Smokeshop Vape Shop Convient Store Gas Station Retail Store or Market Other
How did you hear about us? * Choose one-- Sales Reps -- Daniel Eddie Edgar Edwin Juliet Shawn ---------------- Email Blast Google Referral Tradeshow Postcard Instagram B2B Wholesale Magazine Phone Call In-Person Visit Other
This address MUST match the address on your tobacco license, as required by law! *I am entering the address for my tobacco license, and understand this is where shipments must be sent.
My shipping is the same as the billing. Uncheck this if your shipping address is different from your billing address.
Address 1 *
Address 2
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EIN Number * Enter your EIN number. If you do not have one, you can obtain one from the IRS. If you do not have an EIN, you may submit your Social Security # and a W-9.
Enter your EIN number. If you do not have one, you can obtain one from the IRS. If you do not have an EIN, you may submit your Social Security # and a W-9., in a .pdf or .jpg or .png format.*
Business License Number * Enter your Business License number.
Please upload your business license if you have one, in a .pdf or .jpg or .png format.*
State Seller's Permit Number * This is called a Retail Tax ID in some states.
Please upload your seller's permit/retail tax ID in a .pdf or .jpg or .png format.*
Tobacco License Number *
Please upload your tobacco license in a .pdf or .jpg or .png format.*
Tobacco License Expiration * The expiration date must match the uploaded license.
Tobacco License Type * Choose one Retail Wholesale Distributor Manufacturer
What is 6 + 6? *
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