Royal Jewelry Wholesale Access Form

Welcome to Royal Jewelry's wholesale program. Please fill out the details below to apply for access to our exclusive wholesale prices and products.

Business Information

Business Type*

Individual

Corporation

Partnership

Legal Name of Corporation/Individual:*

DBA (Doing Business As)*

Mailing Address*

City, State, ZIP Code*

Shipping Address*

Residential

Commercial

Contact Information

Contact No*

Fax Number

Email Address*

Website URL (if applicable)

Business Details

Date Business Commenced*

Federal ID Number*

JBT Listing*

Yes

List of Authorized Buyers (if applicable)

Owner Information

Name of Owner(s)*

Contact No*

Home Address*

Social Security Number*

Driver’s License Number*

Spouse Information (If Applicable)

First Name

Last Name

Social Security Number

Driver's License Number

Sales Tax Information

Sales Tax Certificate of Exemption Statement

Certificate Number*

State of Issue*

Bank Information

Bank Name*

Contact Person & Number*

Account Number*

Authorization for Bank Information Release and Check Dishonor Procedure Acknowledgment.

Date and Signature for Bank Authorization

Trade References

Reference 1

Reference 1 Name*

Reference 1 Telephone*

Reference 1 Email ID*

Reference 2

Reference 2 Name*

Reference 2 Telephone*

Reference 2 Email ID*

Personal Guarantee (If Applicable)

This section should be filled out by the guarantor who unconditionally and irrevocably guarantees payment of all obligations incurred by the applicant

Guarantor Name

Guarantor ID Number

Guarantor Date

Guarantor Date of Birth

Guarantor Social Security Number

Guarantor Address Details (State, Zip, City, Street Address)

Terms and Conditions

Please take a moment to read and agree to Royal Jewelry's Terms and Conditions. By doing so, you acknowledge and accept our guidelines on merchandise returns, personal guarantees, and dispute resolution. Note that legal matters are resolved in Atlanta, GA. To complete the process, enter your first and last name, and set up your login email and password for our website.

First Name

Last Name

Password

Applicant Full Name*

Application Date*

Applicant Title*