TJS New Account Form

NEW ACCOUNT APPLICATION

TJ Sheehan Distributing
Thank you for your interest in working with us. Please complete the following form in full.

If you have any questions, reach out to us at web.tjsheehan@tjsheehan.com
Are you a TJ Sheehan Sales Rep filling out this application on behalf of an account?
Account Email
A copy of the New Account Form you fill out below will be sent to this email
New accounts will be built within 3 business days of form submission. If you need an order sooner, we will try to accomodate the request. Please mark the request as urgent and let us know why.

Any new account set ups that require next day delivery need to be submitted no later than 12:00pm to give the analyst team and operations department adequate time to build the account profile.
Is this an urgent request?
Why is this request urgent?
Is this replacing an existing account
What is the old Account Number?
e.g. DA123
Should the inventory be copied to the new account?
When does the account need their first delivery?

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate

New Account Contact Information
Do you already do business with us at another location?
Please list your other businesses below
Licensee/ Premises Name
(LLC, Corp, Inc. Etc. Name)
Trade Name
(DBA Name)
Account's Physical Address

Street Address

Street Address Line 2

City

Zip Code
What County is the Retail Account located in NY?
Business Phone Number
Format: (000) 000-0000.
Primary Contact

First NameLast Name
Primary Contact's Phone Number
Format: (000) 000-0000.
Primary Contact's Email
example@example.com
Buyer (If different than the Primary Contact)

First NameLast Name
Buyer's Phone Number
Format: (000) 000-0000.
Buyer's Email
example@example.com
Please take a photo OR upload an image of Applicants State Issued Resale Certification (ST-120):
Take Photo- ST-120
Upload an Image- ST-120

Cancelof

NEW ACCOUNT APPLICATION