Catalog

Catalog

OPEN ACCOUNT

Open Account Application



Account Name
DBA
Billing Address
City
State
Zip Code
Telephone
Fax
E-Mail
Buyers Name
Title
AP Name
Type of Business
Date Established
Yrs in Business
Print Name
Signature
I hereby certify: I hold a valid sellers permit, permit number :

issued pursuant to the Sales and Use Tax Law, that I am engaged in the business of selling furniture. That tangible personal property described herein which I shall purchase from Homey Design will be resold by me in the form of tangible personal property. Provided however; that in the event any such property is used for any purpose other than retention, demonstration, or display while holding it for sale in the regular course of business. It is understood that I am required by Sales and Use Tax Law to report and pay tax measured by the purchase price of such property. Description of Property to be purchased: Furniture.

Federal Tax ID#
Signature of Purchaser or Authorized Agent Date
Date
Print Name of Purchaser or Authorized Agent
Title
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