Maya Tea Wholesale Application
Thank you for your interest in opening a wholesale account with Maya Tea Company! Please fill out the form below with your information and we will be in touch. 
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Business Name *
Applicant's / Owners Full Name *
Business / Delivery Address (Please Include Street/City/State/Zip Code) *
Billing Address (If different than above)
Phone Number *
Alt. Phone Number
Email(s) *
Website
Year Established *
License / Resale # *
Federal Tax ID *
Authorized purchasers(s) for this account *
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