This is an application for a wholesale account at Empire Imports, LLC. After you submit your application, your documents will be verified before your account is activated. No personal or customer accounts will be approved.

Country

State

Username *

Email address *

Password *

First name *

Last name *

Company *

Website

Telephone *

Cell Phone

Business Type *

How did you hear about us? *

Billing Address

Address 1 *

Address 2

City *

Postcode *

Billing Email

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.

Please upload your EIN letter from the IRS (or a W-9 if using your social security number) 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 *

What is 6 + 6? *

Your personal data will be used to support your experience throughout this website, to manage access to your account, and for other purposes described in our privacy policy.

Billing Address

Shipping Address