New Customer Application

You may need the below documentation to complete this application:

1. Sales Tax Exemption / Resale Certificate

a. Your state may or may not require this documentation. If you are unsure if you require one or need assistance obtaining one, please visit: https://www.tax-id-bureau.com/resale-certificate-sales-tax-exemption/

b. If your state is one that only requires submission after ‘x’ dollar amount, we highly recommend going ahead and submitting this document.

c. While a Resale Permit does have the correct number on the document, it cannot be used as a replacement for the Certificate.

d. If a resale certificate is not submitted, we will charge tax until a form is turned in and Processed by Propét. We will not be able to go back and correct any orders submitted prior to submission.

2. Credit Card Tokenization

a. If credit card or prepayment terms are required, you will receive a secure link to tokenize your payment method. This step must be completed before your orders can be processed for shipment.

3. W9

a. We cannot open an account without this document.

You can save this form to complete later, to do this, please follow the below instructions.

Customer Details:

Propét Representative

For an up to date rep list by location please visit: https://propetfootwear.com/reps

Prospect number (if available)

Business Legal Name:

Business Name

DBA/Trade Name(s)

DBA

Date Established:

Date

Type of Business:

Business Category:

*For Medical Accounts Only - Will you be a part of the PedRX Program?

Type of Medical Service:

FEIN Number

Is your business Sales Tax Exempt or Taxable?

**Note, some states do not have a Sales Tax Exemption Certificate or only require one after certain amount of sales. If you require one after a certain amount of sales, you should still input your certificate.

How to know if you're Tax Exempt?

Sales Tax Exemption/Resale Number(s) (this is not your EIN number):

Sales Tax Exemption/Resale #

File Upload - Exemption/Resale Certificate If a valid Exemption/Resale Cert is not uploaded account will be charged Sales Tax. ***Please note, a sales permit is not the same as the certificate and cannot be accepted.

Exemption/Resale Cert ***Please note, a sales permit is not the same as the certificate and cannot be accepted

Owner/Primary Contact:

Primary First NamePrimary Last Name

Owner/Primary Phone Number

Primary Phone NumberFormat: (000) 000-0000.

Owner/Primary Email

example@example.com

Buyer Contact

Buyer First NameBuyer Last Name

Buyer Phone Number

Buyer Phone NumberFormat: (000) 000-0000.

Buyer Email

example@example.com

What Email would you like to use within NuOrder for purchasing?

example@example.com

AP Contact

AP First NameAP Last Name

AP Phone Number

AP Phone NumberFormat: (000) 000-0000.

AP Email

example@example.com

Paperless Invoicing:

Will you be selling online?

By Signing Below I agree that I will notify Propét and complete an Online Selling Agreement before Selling Online in the future.

New Customer Application

Online Seller Application