CUSTOMER APPLICATION

Legal Company Name:

DBA:

Headquarter Address:

Billing Address:

VAT Number (If Applicable):

Contact Email:

Phone Number:

Fax Number:

Corporation No:

Federal Tax ID No:

Resale No:

DUNS No:

Years in Business:

Number of Employees:

Legal Entity:

Corporation LLC Partnership Sole Proprietorship

Owner/s :

Officers:

Account Payables Contact:

Payable Phone No:

Are you a division or a subsidiary of any other company? Yes No

Parent Company Name:		Address:
Phone Number:
Fax Number:

Type of terms requested:

Net 30 Cash advance/Prepaid Credit card (add CC Processing)

Requested Credit Limit:

Estimate Purchase per Year:

Upload my own credit sheets Enter financial, bank & trade references


Upload my own credit sheets:	*only pdf files

Enter financial, bank & trade references

Please upload copies of current and prior year audited financial statements:

*only pdf files

Bank Reference

Bank Name:

Phone/Fax:

Address:

City:

State:

Zip:

Account No:

Contact name:

Trade References

	Name	Address	Contact Email	Phone	Fax
1
2
3

Ultra PRO Contact

Please provide the name of your Ultra PRO contact or sales rep:

Product Line Interests

Please select all product lines that you are interested in:

Accessories (collecting supplies, gaming accessories)
Entertainment (board games)
Creative Solutions (photo protection, protective supplies)
TableTopics (conversation starters)
SP Images Distribution
Legion Supplies
Others / Custom (please describe):

Shipping Information

Ship to Company Name:

Ship Via:

Address:

Freight terms:

Freight Prepaid
FOB Factory, FRT COL
FOB Prepay and ADD
FRT – 3 rd party billing
C.I.F. Destination billing

Phone Number:

Fax Number:

TERMS OF AGREEMENT

This agreement shall apply to future credit and any existing debt owed by the undersigned, to Ultra Pro International, LLC., or any of its wholly owned affiliates (collectively “ULTRAPRO”). ULTRAPRO is authorized to inquire of our bank and trade references to evaluate and update our credit worthiness and may contact these references anytime. I/We release and hold ULTRAPRO harmless from any liability which may result from the disclosure of credit rating information. If this agreement is presented via facsimile or email, it will be considered the equivalent of an original document. If the credit terms are extended in reliance on the information contained herein, I/We agree to the following: (1) To pay ULTRAPRO within 30 days from invoice date unless otherwise agreed to, in advance, by ULTRAPRO; (2) The customer hereby agrees to pay all invoiced charges as well as any cost of collection or legal fees should such action be necessary due to non-payment of account; and (3) If a lawsuit is commenced, I/we agree such lawsuit may be brought in a court of competent jurisdiction in Los Angeles, California, and waive the right to any other jurisdiction or venue. I understand and agree to the above terms.

I acknowledge that the above is a true and accurate representation of the company I work for. I further represent that I am allowed to sumbit this information on behalf of the company I work for.

Name:		Legal Company Name:
DBA:		Date:

UNIFORM SALES & USE TAX EXEMPTION/RESALE CERTIFICATE — MULTIJURISDICTION – US ONLY

The below-listed states have indicated that this certificate is acceptable as a resale/exemption certificate for sales and use tax, subject to the notes on PDF. The issuer and the recipient have the responsibility to determine the proper use of this certificate under applicable laws in each state, as these may change from time to time.

Issued to Seller:

Address:

I certify that:

Name of Firm(Buyer):

Is engaged as a registered:

Wholesaler
Retailer
Manufacturer
Seller (California)
Lessor (see notes on PDF)
Other (Specify)

Address:

and is registered with the below-listed states and cities within which your firm would deliver purchases to us and that any such purchases are for wholesale, resale, or ingredients or components of a new product or service1 to be resold, leased, or rented in the normal course of business. We are in the business of wholesaling, retailing, manufacturing, leasing (renting) selling (California) the following:

Description of Business:

General description of tangible property or taxable services to be purchased from the Seller:

Upload resale certificate:

*only pdf files

State	State Registration, Seller’s Permit, or ID Number of Purchaser
		Add More State

I further certify that if any property or service so purchased tax free is used or consumed as to make it subject to a Sales or Use Tax we will pay the tax due directly to the proper taxing authority when state law so provides or inform the Seller for added tax billing. This certificate shall be a part of each order that we may hereafter give to you, unless otherwise specified, and shall be valid until canceled by us in writing or revoked by thecity or state.

I have read the Instructions and FAQ, Under penalties of perjury, I swear or affirm that the information on this form is true and correct as to every material matter.

"Buy Now" links are provided solely for convenience of finding third-party sellers of the product. Ultra PRO International is not responsible for listing information accuracy, prices, shipping, warranties, and sales or return policies of third-party sellers.