At this time we cannot ship to Hawaii, Alaska or any U.S. Territory.

Company Name *

DBA (if Any)

Type of Business *

Individual/Sole Proprietor
Corporation/LLC/LLP
Partnership

Contact First Name *

Contact Last Name *

Contact Title *

Contact Email *

Contact Phone *

Street Address *

Street Address 2

City *

State *

Zip *

Country

Website

Years in Business *

Copy of Business License

Copy of Sales Tax ID

Required if you are claiming Tax Exempt status

Copy of Sales Tax Exemption Certificate

Required if you are claiming Tax Exempt status (Please complete one of the forms below)

Fillable Uniform Sales & Use Tax Exemption Certificate

Download Uniform Sales & Use Tax Exemption Certificate

Fillable State of Georgia Sales Tax Certificate of Exemption

Download State of Georgia Sales Tax Certificate of Exemption

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If you heard about us through a Sales Rep, please tell us their name:

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Thank you for applying for a Kings Trade Account! Please allow up to 2 business days for a confirmation email. If you have any questions or concerns, please call 404.355.8995 and we will be happy to assist you.

SKU:	JLAN-121A
Dimension D:	17.5
Dimension H:	19.5
Dimension W:	60

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