Checkout Information

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Retail Wholesale What is Wholesale? [|||]
Required ItemFirst Name:
Required ItemLast Name:
Required ItemEmail Address (User Name): Example: name@yahoo.com
Required ItemConfirm Your Email: Case sensitive
Required ItemPassword:
Company / Institution Name: Must match: Tax Exempt / Wholesale / Net-30
Required ItemTelephone #:
Telephone # (2):
Telephone # (3):
Telephone # (4):
Fax Number:
Required ItemBill To Address:
Example: 105 Main Street
  Apt. or Suite #
Required ItemCity:
Required ItemState/Province/Region:
  		— or —

Not in the United States or Canada? Enter your province or region into the text field above.
Required ItemZip Code:  If you do not have a Zip Code, please put “NONE”
Required ItemCountry:
Tax Exempt Section: (Not Required - If filled, please add "Institution Name" above. Verification of information is required so please submit order with taxes (we will check exemption while processing order). Taxes will be refunded before payment is processed and after tax status is verified.
Only customers shipping within the State of Texas and eligible for tax exempt status by the State of Texas will be able to purchase Tax Exempt. Tax I.D. Number and Company / Institution name must match above registration information. Your order will be delayed or criminal tax penalties will be issued to you by the Texas Government if status is found incorrect or untrue.

All customers shipping outside the State of Texas will automatically be tax exempt.
Tax ID#:
Required ItemTax Exempt Agreement: I have read and have understood all of these terms and conditions.
Required Item Attach Tax Exempt Certificate: Download From Here Upload Certificate Here ->
Required Item Charge Account Section: (Not Required - Only for businesses with "Accounts Receivable" department.)
Only Customers applying to open a charge account with us with Net-30 Terms. Company / Institution Name must match above registration information. (Approval Required)
Only Customers applying to open a charge account with us with Net-30 Terms. Company / Institution Name must match above registration information. (Approval Required)
Net-30 Agreement: I have read and have understood all of these terms and conditions.
Attach Charge Account Form Download From Here Upload Form Here -->
 


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