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Thank you for your interest in Boss Office Products, Inc. The following information and application are required to open an account on prepaid terms, or to establish credit.:

Company Name: *

Description of Business: *

Buying group affiliations, if any (list all that apply):

If 'other', please describe::

List all Ecommerce Website URLs where you will be reselling Boss products:

List all ecommerce 3rd party marketplace websites where you will be reselling Boss products (include URL and your storefront name for each)::

Boss in its sole determination will approve (or not) a new prospective account customer to be an authorized reseller of Boss products and which of the above category(s) the new account customer will be approved for, and agrees to adhere to reselling Boss products exclusively to the “approved for” reseller distribution category(s) which will be noted in the approval letter sent by Boss.:

Any violation of selling/reselling of Boss products to a non-approved reseller category of distribution may result in customer losing reseller approval authorization and, in Boss’s sole determination, it may close the customers account with Boss. :

In addition, if by violating the approved authorized reseller category creating an authorized use of BOSS intellectual property including it’s federally registered trademark, Boss has the right to prosecute the unauthorized use of its protected intellectual property to the fullest extent allowed by law.:

By signing/submitting this application, you acknowledge that you are authorized on behalf of your company to sign this application and agree to be bound by Boss’s Sales and MAP policies, terms, legal compliance (which is published on Boss’s website www.bosschair.com) and the granted authorized reseller category(s).:

Company Information:

Legal Business Name: *

dba:

Year Business Established: *

Website:

Billing Address:

Street Address: *

Street Address Line 2:

City: *

State / Province:

*

Postal / Zip Code: *

Country:

*

Telephone: *

Fax:

General Email:

Email Addresses for Invoice & Statement Deliver. (if none provided, they will be emailed to your Accounts Payable).:

Name:

Email Address:

Invoices:

Statements:

Name:

Email Address:

Invoices:

Select

Statements:

Select

Name:

Email Address:

Invoices:

Select

Statements:

Select

Name:

Email Address:

Invoices:

Select

Statements:

Select

Ship to / Physical Address (If different than above):

Street Address:

Street Address Line 2:

City:

State:

Zip Code:

Country:

Additional Contacts:

Accounts Payable (required):

Name: *

Email: *

Telephone: *

Buyer (required):

Name: *

Email: *

Telephone: *

Customer Service:

Name: *

Email: *

Telephone: *

How did you hear about Boss?:

Boss Sales Rep Name:

Previous Boss Account #:

Other:

Federal Tax ID#: *

Please upload a copy of your Home State & California permit:

Note: All shipments to California will be charged applicable California Sales Tax, unless a valid California Resale Certificate/Permit is provided. You can upload a copy of your California Resale permit above and see last section of this application to fill out the multi-jurisdiction certificate:

Type of Business:

*

Credit Request:

Would you like to apply for credit? :

Yes
No

*

Do you have a pending purchase order? :

Yes
No

*

Panding order value $: *

DUNS (D&B)#:

Anticipated Monthly Purchases: *

Trade References within the Furniture Industry:

Company Name: *

Contact: *

Account Number: *

Email: *

Phone Number: *

Fax:

Company Name: *

Contact: *

Account Number: *

Email: *

Phone Number: *

Fax:

Bank Reference:

Bank Name: *

Account #: *

Contact Name: *

Email: *

Phone Number: *

Authorization to open an account with Boss Office Products, Inc. & Authorization to release Credit Information:

The confidential information herein is for the purpose of obtaining merchandise from Boss Office Products, Inc. I certify that all information given by me on this application is accurate to the best of my knowledge.:

By signing, I hereby authorize to open and account and/or for the financial institutions listed in this application to release necessary information to Boss for which credit is being applied for.:

Please upload a copy of your voided company check to expedite the process. Attach list if more than one bank and or account:

NOTE: Your account will be setup on prepaid cashier’s check terms, until credit can be established.:

The confidential information herein is for the purpose of obtaining merchandise from Boss Office Products, Inc. I certify that all information given by me on this application is accurate to the best of my knowledge.:

Name : *

Title: *

Authorized Applicant Signature:

*

Date: *

UNIFORM SALES & USE TAX RESALE CERTIFICATE — MULTIJURISDICTION:

The below-listed states have indicated that this certificate is acceptable as a resale/exemption certificate for sales/use tax, subject to the instructions and notes on pages 2─6.:

The issuing Buyer and the recipient Seller have the responsibility to determine the proper use of this certificate under applicable laws in each state, as these may change from time to time. This form was revised as of October 14, 2022.:

Issued to Seller: *

Address: *

I certify that::

Name of Firm (Buyer): *

Address: *

and is registered for sales/use tax with the below-listed states and cities within which Seller would deliver purchases to Buyer and that any such purchases are for wholesale, resale, or ingredients or components of a new product or service to be resold, leased, or rented in the normal course of business. :

Buyer is in the business of wholesaling, retailing, manufacturing, leasing (renting), or selling the following:

Description of Business:

General description of tangible property or taxable services to be purchased from the Seller: *

State Resale Identification Information:

AL - State Registration, Seller's Permit, or ID Number of Purchaser:

AR - State Registration, Seller's Permit, or ID Number of Purchaser:

AZ - State Registration, Seller's Permit, or ID Number of Purchaser:

CA - State Registration, Seller's Permit, or ID Number of Purchaser:

CT - State Registration, Seller's Permit, or ID Number of Purchaser:

FL - State Registration, Seller's Permit, or ID Number of Purchaser:

GA - State Registration, Seller's Permit, or ID Number of Purchaser:

HI - State Registration, Seller's Permit, or ID Number of Purchaser:

ID - State Registration, Seller's Permit, or ID Number of Purchaser:

IL - State Registration, Seller's Permit, or ID Number of Purchaser:

IA - State Registration, Seller's Permit, or ID Number of Purchaser:

KS - State Registration, Seller's Permit, or ID Number of Purchaser:

KY - State Registration, Seller's Permit, or ID Number of Purchaser:

ME - State Registration, Seller's Permit, or ID Number of Purchaser:

MD - State Registration, Seller's Permit, or ID Number of Purchaser:

MI - State Registration, Seller's Permit, or ID Number of Purchaser:

MN - State Registration, Seller's Permit, or ID Number of Purchaser:

MO - State Registration, Seller's Permit, or ID Number of Purchaser:

NE - State Registration, Seller's Permit, or ID Number of Purchaser:

NV - State Registration, Seller's Permit, or ID Number of Purchaser:

NJ - State Registration, Seller's Permit, or ID Number of Purchaser:

NM - State Registration, Seller's Permit, or ID Number of Purchaser:

NC - State Registration, Seller's Permit, or ID Number of Purchaser:

ND - State Registration, Seller's Permit, or ID Number of Purchaser:

OH - State Registration, Seller's Permit, or ID Number of Purchaser:

OK - State Registration, Seller's Permit, or ID Number of Purchaser:

PA - State Registration, Seller's Permit, or ID Number of Purchaser:

RI - State Registration, Seller's Permit, or ID Number of Purchaser:

SC - State Registration, Seller's Permit, or ID Number of Purchaser:

SD - State Registration, Seller's Permit, or ID Number of Purchaser:

TN - State Registration, Seller's Permit, or ID Number of Purchaser:

TX - State Registration, Seller's Permit, or ID Number of Purchaser:

UT - State Registration, Seller's Permit, or ID Number of Purchaser:

VT - State Registration, Seller's Permit, or ID Number of Purchaser:

WA - State Registration, Seller's Permit, or ID Number of Purchaser:

WI - State Registration, Seller's Permit, or ID Number of Purchaser:

I further certify that if any property or service so purchased tax-free is used or consumed by Buyer so as to make it subject to sales/use tax, Buyer will pay the tax due directly to the proper taxing authority when state law so provides or inform the Seller for added tax billing.:

This certificate shall be a part of each order that Buyer may hereafter give to Seller, unless otherwise specified, and shall be valid until canceled by Buyer in writing or revoked by the city or state.:

Under penalties of perjury, I swear or affirm that the information on this form is true and correct as to every material matter.:

Authorized Signature (Owner, Partner, or Corporate Officer, or other authorized signer of Buyer):

*

Title: *

Date: *

Dealer Application