Dealer Application

Dealer Application
Thank you for your interest in Boss Office Products, Inc. The following information and application are required to open an account on prepaid terms, or to establish credit.
Company Name:*
Description of Business:*
Buying group affiliations, if any (list all that apply):
You acknowledge that you are applying to be an authorized reseller of Boss Office Products Inc, DBA Norstar Office Products / DBA Presidential Seating. To grant the authorization, Boss needs to understand the category of your business and the channels of distribution you are applying for. Please check all the account categories and distributions channels that you are applying to resell Boss products to (select all that apply):*

Office Furniture & Products DealersOffice Furniture Wholesaler/DistributorOffice Furniture Buying GroupResidential Furniture RetailerResidential Furniture Wholesaler/DistributorResidential Furniture Buying GroupDesign/Purchasing FirmEcommerce Retailer (B2B & B2C)Other
If 'other', please describe:
List all Ecommerce Website URLs where you will be reselling Boss products:
List all ecommerce 3rd party marketplace websites where you will be reselling Boss products (include URL and your storefront name for each):
Boss in its sole determination will approve (or not) a new prospective account customer to be an authorized reseller of Boss products and which of the above category(s) the new account customer will be approved for, and agrees to adhere to reselling Boss products exclusively to the “approved for” reseller distribution category(s) which will be noted in the approval letter sent by Boss.

Any violation of selling/reselling of Boss products to a non-approved reseller category of distribution may result in customer losing reseller approval authorization and, in Boss’s sole determination, it may close the customers account with Boss. In addition, if by violating the approved authorized reseller category creating an authorized use of BOSS intellectual property including it's federally registered trademark, Boss has the right to prosecute the unauthorized use of its protected intellectual property to the fullest extent allowed by law.

By signing/submitting this application, you acknowledge that you are authorized on behalf of your company to sign this application and agree to be bound by Boss’s Sales and MAP policies, terms, legal compliance (which is published on Boss’s website www.bosschair.com) and the granted authorized reseller category(s).
Company Information
Legal Business Name:*
dba:
Year Business Established:*
Website:
Billing Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Telephone:*
Please enter a valid phone number.
Fax:
Please enter a valid phone number.
General Email:
example@example.com

Email Addresses for Invoice Delivery (If none provided, invoices will be emailed to your accounts payable):

	Name	Email
1
2
3

Ship to / Physical Address (If different than above):

Street Address

Street Address Line 2

CityState

Zip CodeCountry

Additional Contacts:*

	Name	Email	Telephone
Accounts Payable (required)
Buyer (required)
Customer Service

How did you hear about Boss?
Boss Sales Rep Name:
Previous Boss Account #:
Other:
Will your orders be drop shipped into CA?*

YesNo
Do you accept billing of all CA tax on orders shipping into CA? If no, you will be asked to upload your CA Resale Permit.

NoYes
If you are unsure on how to answer the above question, please click here for additional information on drop shipments in California.
Please provide a copy of your CA Reseller Permit: *

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Federal Tax ID#:*
Please upload a copy of your state's reseller permit:*

Cancelof
Type of Business:*
Please provide the state in which you are incorporated:
Owner's Name:

First NameLast Name
Owner's Email:
example@example.com
Owner's Phone:
Please enter a valid phone number.
Owner's Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Credit Request
Would you like to apply for credit?*

YesNo
Do you have a pending purchase order?*

YesNo
Value of purchase order:*
DUNS (D&B)#:
Anticipated Monthly Purchases:*
Trade References within the Furniture Industry
Company Name:*
Contact:*

First NameLast Name
Account Number:*
Email:*
example@example.com
Phone Number:*
Please enter a valid phone number.
Fax:
Please enter a valid phone number.
Company Name:*
Contact:*

First NameLast Name
Account Number:*
Email:*
example@example.com
Phone Number:*
Please enter a valid phone number.
Fax:
Please enter a valid phone number.
Bank Reference
Bank Name:*
Account #:*
Contact Name:*

First NameLast Name
Email:*
example@example.com
Phone Number:*
Please enter a valid phone number.
Please upload a copy of your voided company check to expedite the process. Attach list if more than one bank and or account.*

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Authorization to open an account with Boss Office Products, Inc. & Authorization to release Credit Information
The confidential information herein is for the purpose of obtaining merchandise from Boss Office Products, Inc. I certify that all information given by me on this application is accurate to the best of my knowledge.

By signing, I hereby authorize to open and account and/or for the financial institutions listed in this application to release necessary information to Boss for which credit is being applied for.

NOTE: Your account will be setup on prepaid cashier’s check terms, until credit can be established.
The confidential information herein is for the purpose of obtaining merchandise from Boss Office Products, Inc. I certify that all information given by me on this application is accurate to the best of my knowledge.
Name*

First NameLast Name
Title:*
Authorized Applicant Signature:*

Clear
Date:*

MonthDayYear
Date

UNIFORM SALES & USE TAX RESALE CERTIFICATE— MULTIJURISDICTION
Issued to Seller: Boss Office Products, Inc.

1862 Firman Dr. Richardson, TX 75081
Name of Firm (Buyer):*
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
General description of tangible property or taxable services to be purchased from the Seller:*
is engaged or registered as:*

WholesalerRetailerManufacturer SellerLessorOther
State Resale Identification Information:

	State Registration, Seller’s Permit, or ID Number of Purchaser
AL
AR
AZ
CA
CT
FL
GA
HI
ID

	State Registration, Seller’s Permit, or ID Number of Purchaser
IL
IA
KS
KY
ME
MD
MI
MN
MO

	State Registration, Seller’s Permit, or ID Number of Purchaser
NE
NV
NJ
NM
NC
ND
OH
OK
PA

	State Registration, Seller’s Permit, or ID Number of Purchaser
RI
SC
SD
TN
TX
UT
VT
WA
WI

I further certify that if any property or service so purchased tax-free is used or consumed by Buyer so as to make it subject to sales/use tax, Buyer will pay the tax due directly to the proper taxing authority when state law so provides or inform the Seller for added tax billing. This certificate shall be a part of each order that Buyer may hereafter give to Seller, unless otherwise specified, and shall be valid until canceled by Buyer in writing or revoked by the city or state.

Under penalties of perjury, I swear or affirm that the information on this form is true and correct as to every material matter:
Authorized Signature:*

Clear
Title*
Date*

MonthDayYear
Date
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Dealer Application

Company Information

Credit Request

Trade References within the Furniture Industry

Bank Reference

Authorization to open an account with Boss Office Products, Inc. & Authorization to release Credit Information

UNIFORM SALES & USE TAX RESALE CERTIFICATE— MULTIJURISDICTION