Distributor Account

RM_Stats
Account Information
Email^*
Username^*
Password^*
Password must be at least 7 characters long.
Enter password again^*
Password must be at least 7 characters long.
Company Name^*
Shipping Address

First Name

Last Name

Company

Street Address 1

Street Address 2

City

State or Region

Country

Zip

Phone Number^*
Fax Number
G.L Code
Federal Tax Identification Number
Billing Address

First Name

Last Name

Company

Street Address 1

Street Address 2

City

State or Region

Country

Zip

Phone Number

Email Address ^*

US Credit Application
Sales Department
Email
Phone number
Orders Department
Email
Phone number
Account Payables Department
Email
Phone number
Marketing Material Email
Fax
Principal(s) in Business
Officer(s)

Partner(s)

Owner(s)

Contact 1
Name
Title
Phone Number
Email
Contact 2
Name
Title
Phone Number
Email
Contact 3
Name
Title
Phone Number
General Information
Business
Corp

Proprietorship

Partnership

D & B #
Sales Tax Exempt No.
Tax Exemption Certification
Copy of the Tax Exemption Certificate must be included with the application, if we do not receive one your company could be charged a sales tax.

Business References
Reference 1
Company Name
City
Phone Number
Contact Name
Email Address
Reference 2
Company Name
City
Phone Number
Contact Name
Email Address
Reference 3
Company Name
City
Phone Number
Contact Name
Email Address
Reference 4
Company Name
City
Phone Number
Contact Name
Email Address
Terms and Conditions:

For and in consideration of the extension of credit to applicant, the undersigned promises to pay to the order of Vonos, LLC. at its offices in Orlando, Orange County, Florida, USA all charges to the account of the applicant according to the published invoice terms. In the event said account becomes past due, the undersigned agrees to pay interest at a rate of the lower of 10% or the maximum allowed by state law. This application is to extend credit, when approved, all orders, contracts, and extensions of credit made pursuant here shall be deemed to have been made and entered into in the city of Orlando, Orange County, Florida. Applicant consents to jurisdiction of any state court of Florida and of any Federal court therein. The laws of the State of Florida shall control provisions of this application. Being duly authorized, the undersigned represents and warrants that the information provided is accurate and true, and you are entitled to rely on this information as part of the consideration to grant credit.

Terms and Conditions^*
I have read and fully understand the above. (Officer, Partner or Proprietor must sign)

Printed Name
Title
Date
Payment Options:

Credit Card: MasterCard, VISA, American Express

Wire Transfer: Information available upon request.

No checks accepted. Only ACH or wire transfers.