JDR Brazilian Elegance
North Dakota Requires that we have an updated resale license number in our files. Please fill out
and return the following information along with a copy of your resale license, a business card, and a canceled check with the business name on the heading.
Name of license owner:___________________________________________________
Your Resale License Number:_______________________________ State Issued:________
Phone :_________________________ Business Phone:________________________
Web Site Address:________________________________________________________
Shipping Address, if different:_____________________________________________
I HEREBY CERTIFY THAT I AM IN THE BUSINESS OF SELLING THE FOLLOWING:
EMBROIDERY SUPPLIES:________BOOKS _______THREADS______
PRINTS OR KITS ______NOTIONS______AND OTHER EMBROIDERY SUPPLIES_______
Initial Each line that applies.
ALSO CERTIFIED: THAT THE ABOVE MERCHANDISE WILL BE RE-SOLD IN THE SAME FORM.
I understand that any item purchased from JDR Brazilian Elegance that is used for personal purposes are to be purchased at retail costs. I certify that the above license is for the purpose of reselling products purchased from JDR Brazilian Elegance. It is understood that I may be required by the sales and use tax law to report and pay appropriate use tax in my own state.
Signature Title Date
**** Required that all fields be filled.
You may fax (1-800-501-3008) (International Fax: 1-757-257-6648) mail or jpeg and email this information.
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