Dealer Application

Please send or fax this form to: Horse Amour, 804 Eaton Hill East, Castleton, VT 05735

Fax: 802-468-2151

Name of Store/Catalog:______________________________# years in business:______

Telephone#:__________________________Fax#:__________________________

Delivery address:_______________________________________________________

Billing address:_________________________________________________________

Federal ID#:__________________________State Tax Resale#:__________________

Name of purchaser/contact person:_________________________________________

web address:______________________________email:________________________

I certify that the above information is correct. I understand that overdue accounts will be assessed a $5.00 fee for every 30 days beyond the 30-day-net period.

Signature of Purchaser:________________________________Date:_______________

Approved accounts will be net 30 days. Thankyou.

Po© Sue Cook 2015