New Customer Request Form v3

Uniform Sales & Use Tax Certificate - Multijurisdiction

Purchaser will be held liable for any tax, interest or penalties if purchaser uses the product in a taxable manner or is otherwise not eligible to claim this exemption.
Business Name *
Your State Sales/Resell Tax ID Number *
This is not your Federal Tax ID. Please enter your state sales tax ID number/resell #.
State Tax ID Expiration (If Applicable)
Does your company resale apparel *

Yes No
Full Name *

First Name Last Name
E-mail *
Phone Number *
ex. 123-456-7890
Fax Number
ex. 123-456-7890
Primary Type of Business (You must be in the resell business within the apparel industry.) *

Screen Printer Embroidery Sporting Goods Promotional Products Trophy & Awards Team Sports Dealer Distributor Uniform Company Outdoor Industry/Business Universal Unilink/WePromo
Do you have a Pacific Headwear account number? *

No Yes
Pacific Headwear Account # *
Do you have a CCM (Sport Maska) account number? *

No Yes
CCM Account # *
How Did You Hear About Us?
Do you operate in one of the following states? *
Some states require us to have a copy of their state tax form on file and you may be required to submit additional forms.
Billing Address *

Street Address

Street Address Line 2

City State

Zip Code
If you are trying to sign up for a Canadian account, use this form instead.
Address UPS Zone *

Residential Commercial
Shipping Address (If same as Billing Address, leave blank. Shipping Address can't be a PO Box.)

Street Address

Street Address Line 2

City State

Zip Code
Invoicing Preference *

E-Invoicing (Note: If you select this option, you will receive a separate email confirmation that you will need to confirm.) Mail
Associated Membership
If you are a member of ASI, PPAI or Sage, please provide your #
Are you a part of a buying group?

No Yes
If yes, which buying group(s) are you a part of?

ADA Adventures in Adver. American Diversity American Solution for Business B&N BIG FROG Bluegrass Boundless Network BSN Sports Connect 2 One Crown Trophy Educational Outfit. Embroidme Extra Innings Fullarton Group Fully Promoted/EmbroidMe Geiger Halo Innerworkings Ipromoteu MLB NBS Play It Again Sports Premier Group Proforma Safegaurd/Deluxe Sports Inc Sports Excellence Corp Universal Unilink Purchasing Assoc
Enter Contact Info of Business In-House Salesperson
Newsletter

Yes, please subscribe me to the Augusta Sportswear Brands newsletter.
The undersigned Purchaser (You) certifies that the product or services which will be purchased from Seller, are exempt from sales and use taxes in the states listed on this form in which delivery or performance of said purchase will be made for the following reason: *

Material for Resale Purchaser is a Non-Profit organization State does not collect resale tax
Attach state form below

Browse Files
If you already have your extra state tax form filled out, please submit. You may also email GroupRegistration@augustasportswear.com at a later time. Cancel of
To apply for N30 credit terms, please email your request to
creditapplications@augustasportswear.com
Signature (use your mouse to sign this form before submitting) *
Enter the message as it's shown *
State Tax Form *

I understand that I am required to submit an additional tax form to sign up for an account.
Should be Empty:

Uniform Sales & Use Tax Certificate - Multijurisdiction