WHOLESALE APPLICATION
Business Name Name/Title Address City State Zip Code Telephone Fax E-mail Web Site Resale Tax ID JBT ID Type of Business Jewelry Designer Retail Jeweler Wholesale Manufacturer Wholesale Gem Dealer Other/Description Business Description Years in business Trade References Company name Address City/State/Zip Phone Company name Address City/State/Zip Phone Company name Address City/State/Zip Phone
Business Name
Name/Title
Address
City
State
Zip Code
Telephone
Fax
E-mail
Web Site
Resale Tax ID
JBT ID
Type of Business Jewelry Designer Retail Jeweler Wholesale Manufacturer Wholesale Gem Dealer Other/Description
Business Description
Years in business
Trade References Company name Address City/State/Zip Phone Company name Address City/State/Zip Phone Company name Address City/State/Zip Phone