Oceano Wines Wholesale Credit Application

Oceano Wines Wholesale Credit Application

Complete this form to set up your wholesale account and credit terms with Oceano Wines. Have your business and trade references ready.
Business Information
Legal Business Name
DBA / Trade Name
Business Type
Business Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Shipping Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Main Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Website
Primary Contact
Primary Contact Name

First NameLast Name
Title
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Billing Contact
Billing Contact Name

First NameLast Name
Billing Email Address
example@example.com
Billing Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Licensing / Resale Information
Seller’s Permit / Resale Certificate Number
Business License Number (if applicable)
Upload Resale Certificate or Seller’s Permit

Cancelof
Are purchases intended for resale?
Credit Terms Requested
Requested payment terms
Estimated monthly order volume
Products of interest

Other
Trade References
Trade Reference 1
Trade Reference 2
Business Name
Contact Name

First NameMiddle NameLast Name
Email
example@example.com
Phone
Please enter a valid phone number.Format: (000) 000-0000.
Relationship or Type of Vendor
Business Name
Contact Name

First NameMiddle NameLast Name
Email
example@example.com
Optional Bank Reference
Bank Name
Bank Contact
Bank Email
example@example.com
Authorization
By submitting this application, I certify that the information provided is accurate and complete. I authorize Oceano Wines to contact the trade references listed above for the purpose of evaluating this credit application. I understand that approval of credit terms is at the sole discretion of Oceano Wines and that payment terms may be modified or revoked at any time.
Authorized Representative Name
Title
Date

MonthDayYear
Date
Digital Signature
Should be Empty:

Oceano Wines Wholesale Credit Application

Business Information

Primary Contact

Billing Contact

Licensing / Resale Information

Credit Terms Requested

Trade References

Optional Bank Reference

Authorization