Wholesale Partner Application
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Name (First and Last Name) *
Company Name *
Email *
Phone Number *
Billing Address *
Is the billing address the same as the shipping address ? *
If no, please provide the shipping address.
Sales Tax ID # (Please email a copy of your state's resale certificate ST-5 to sales@xocolatlchocolate.com.) *
What products are you interested in? *
Describe your business. *
Any other notes/comments:
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