Dealer Application

ONLINE DISTRIBUTOR/DEALER APPLICATION

COMPANY NAME
PRIMARY CONTACT NAME
PHONE
PHYSICAL ADDRESS
CITY
STATE
ZIP
FFL NUMBER
BUSINESS WEBSITE
SALES TAX EXEMPTION	I hereby certify that unless otherwise stated at the time of order, all purchases from Wraithworks are exempt from State Sales and Use Taxes under current rules and regulations by reason of the fact they are purchased for:
RESALE
SALES TAX LICENSE NUMBER
MAP POLICY	It is Wraithworks policy that all authorized dealers adhere to our Minimum Advertised Price (MAP) guidelines. MAP will be strictly enforced.
SIGNATURE
DATE
PRINT NAME
TITLE

OFFLINE DISTRIBUTOR/DEALER APPLICATION