Specializing in Custom Manufacturing of Hand Made, Hand Engraved Western Sterling Silver Show Bits, Spurs, and Snaffles

JT Silver

WHOLESALE APPLICATION FORM

Please download and complete the following application. You may either mail it to us to: P. O. Box 578832, Modesto, CA 95357; fax it to (209) 571-1029; or e-mail it to us at sales@JTSilversmiths.com.

Please remember to sign the application and enclose a copy of your seller's permit. We appreciate your business and look forward to working with you.

 
Business Information  
Parent Company or Branch Names:  
Number of Locations:  
Phone No.  
Fax No.  
E-mail:  
   
Billing Address  
Address:  
City, State, Zip Code:  
Country:  
   
Shipping Address  
Address:  
City, State, Zip Code:  
Country:  
   
Permits  
Years in Business:  
Business License No.:  
Resale Permit No.:  
City:  
State:  
Type of Business:  ____ Sole Proprietorship |  ____ Corporation |  ____ Partnership |  ____ Other
   
Name of Principles  
Name:  
Title:  
Address:  
City, State, Zip Code:  
Country:  
   
Bank References  
Bank Name:  
Address:  
City, State, Zip Code:  
Country:  
Contact:  
Phone No.:  
Fax No.:  
   
Business Reference (1)  
Company Name:  
Contact:  
Address:  
City, State, Zip Code:  
Phone No.:  
   
Business Reference (2)  
Company Name:  
Contact:  
Address:  
City, State, Zip Code:  
Phone No.:  
   

I hereby certify that all the above information is accurate to the best of my knowledge, I understand that any verbal trade or order placed by a representative of my company creates a binding contract between J T Silversmiths and my company.

In addition, I agree to pay all costs of collection, including reasonable attorney fees and court costs. As principal owner or representative of applicant company, I hereby personally guarantee all debts incurred by said company with J T Silversmiths.



___________________________________
Signature

___________________________________
Print Name



___________________________________
Title

___________________________________
Date