Application for Retail Access To AMERMILLS.COM
To obtain access to wholesale pricing available to retailers, complete the following steps:
- Create a user ID and Password by clicking Here.
- Complete this form. All requested information is required.
- Fax the form and a copy of your retail tax certificate to 770-412-1124
Business Name:__________________________________________________________________
Physical Address:
Street: ______________________________________________________________________
City: _____________________________State:______ Zip Code:___________
Credit Card Billing Address:
□ Check here if billing address is same as physical address.
Street: ______________________________________________________________________
City: _____________________________State:______ Zip Code:___________
Sales Tax Information (Required):
Tax ID Number: ___________________________________________________________________
Issuing State: ______________________________________________________________________
Contact Information:
Contact Name: ______________________________________________________________
Contact Email Address:_______________________________________________________________
Business Telephone Number:_________________________________________
□ Check here if Amermills.Com User ID is same as Contact Email Address.
Amermills.Com User ID: _____________________________________________________
Signature: ______________________________________________________________
Title:_______________________ Date:___________________________
You will be notified by email when wholesale pricing will be displayed when using Amermills.Com
