Wholesale Registration Form Jonathan Green Collection Div. Nine Yards Int’l, LLC 295 Seven Farms Drive C237 Daniel Island, SC 29492 [email protected] www.jonathangreencollection.com Phone 843-779-5534 Fax 843-278-9253 Date: All fields are required. Incomplete registration forms will not be processed. Please ensure that your email address is entered correctly. We will provide your User Name and Password via email. After completing this form you may send it to us by email using the button at the top of this page or you may print this form and fax it to us at 843-278-9253. If you have any questions, please call us at 843-7795534. Please allow 2 business days for us to process this request. Customer First Name_________________Customer Last Name______________________________ Business Name __________________________________Phone____________________________ Business Website_________________________________Fax______________________________ Address 1___________________________________Address 2_____________________________ City_____________________________State___________Zip/Postal__________Country_________ Email _______________________________Verify email_________________________________ How did you hear about us? __Online Search __Magazine __Friend__Business Associate __Other (specify) Business Description __ Retailer __Art Gallery __Event Planner __Other (please specify)____ Jonathan Green Collection sells to registered businesses only. S. Carolina businesses must fax a copy of form ST-8A. Businesses from all other states must provide ID numbers from ONE of the following proof of business documents to complete your registration. State Sales Tax No. ________________ Federal Tax No.___________________ Other Business License # ________________________________________________ For “Other Business License” including issuing Agency Name, Date of Issue, and Identification # Signature (typed acceptable if submitting online)________________________________________ I the above signed certify that I hold the valid Vendors Registration named above and that I am in the business of selling the kinds of tangible personal property being purchased from Jonathan Green Collection under this Vendors Registration and that I intend to sell such property in the regular course of my business.