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Business Wholesale Account Form
Please complete a new wholesale account setup form. Once submitted, we will review and setup your account in our system. If you need assistance please call the wholesale department at (217) 679-4315 or reach us by email:
wholesale@upperlimitsinc.com
. Thank you
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* Indicates required question
Email
*
Your email
Name
*
Your answer
Company Name
*
Your answer
Company Email
*
Your answer
Would you like to receive our monthly wholesale newsletter with specials, products updates and more?
*
Yes
No
Business Telephone
*
Your answer
Secondary Phone
Your answer
What is the best time to be reached by phone?
Your answer
Federal Tax Id (FEIN) / State Tax ID
*
Your answer
Full Shipping Address (Street, City, State, Zip Needed)
*
Your answer
Full Billing Address If Different From Shipping Address. (Street, City, State, Zip)
Your answer
Company Website
Your answer
Social Media Links
Your answer
Referred By
Your answer
Preferred Payment Method
*
Credit Card
Bank Transfer (MOQ)
Other:
Preferred Contact Method
Email
Phone
What products are you mainly interested in?
*
Your answer
Additional Information
Your answer
Illinois: CRT-61 for resale in Illinois
https://tax.illinois.gov/content/dam/soi/en/web/tax/forms/sales/documents/sales/crt-61.pdf
Additional Comments
Your answer
Image Urls
Comma separated Image URLs
Your answer
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