Registration
Contact Information
Name
Last Name
Email
Phone
Business Information
Company Name
DBA Name
Address 1
Address 2
City
Zip
Documents Required
Tax ID
Sales Tax Document
OTP/Vape/Tobacco License Number
OTP/Vape/Tobacco License
Federal EIN Document Number (Optional)
Federal EIN Document (FEIN) (Optional)
WHOLESALE ONLY!
I agree that I am a business and that I am creating this account for RESALE purposes only.
Information Provided
I understand that if the information provided on this form is invalid, incorrect or not filled in, my account will not be approved. I understand that the approval process may take up to 72 hours.
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