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New Account Form (Team Weber)
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ACCOUNT INFO
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Alternate/Billing Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
CONTACT INFO
Contact Name
*
First
Last
Contact Email
Contact Phone
*
PERMITS AND LICENSES
Seller's Permit Number
*
Federal ID Number
*
Alcohol Licensee Name
*
Alcohol License Number
*
SALES INFO
Sales Person Name
*
Open Status
*
Year Round
Seasonal
Temporary
If Seasonal, list months open
Account Type
*
Independent
National - Regional Chain
Local Chain
CREDIT INFORMATION
WISCONSIN RESALE CERTIFICATE
Wisconsin Department of Revenue Income, Sales, Inheritance & Excise Tax Division P.O. Box 8903 Madison, WI 53708 (608) 266-2776
Certificate Type
*
Single Purchase
Continuous
Other
Certificate Issued To
*
Operating as
(Grocery, Tavern, Convenience, etc...)
I agree with the statement below
*
YES
NO
I hereby certify that I hold Seller’s Permit Number the tangible personal property or taxable service described herein which I purchase from WDI LLC d/b/a Wisconsin Distributors will be resold, leased, or rented by me; provided, however, that in the event any such property is used for any purpose other than retention, demonstration, or display while holding it for sale, lease, or rental in the regular course of business I understand that I am required by the Sales and Use Tax Law to report and pay the tax measured by the purchase price of such property. Beer, Other Beverages, Mugs, Hats, Shirts, Other Promotional Products, Glassware, Napkins, and Miscellaneous Items. (Description of kind of property purchased must be provided for the certificate to be valid. For a “Single Purchase” certificate, itemize the property purchased. For a “Continuous” certificate, give general description of the kind of property to be purchased for resale, lease, or rental in the regular course of the purchaser’s business.)A “Continuous” certificate giving a general description of the kind of property purchased is good until revoked in writing. If a purchaser, who has given a “Continuous” certificate asserts that he or she is buying for resale property of a kind normally not resold in his business, the seller should ask for a “Single Purchase” resale certificate listing the specific Property.
CREDIT POLICY
I agree with statement below
*
YES
NO
1. All customers applying for credit terms must submit a general credit application provided by WDI LLC, hereinafter called Wisconsin Distributors. 2. All initial purchases will be C.O.D. (Cash On Delivery). Credit terms will be established upon approval of the general credit application. 3. Two Non-Sufficient Fund (NSF) payments in any 30-day period will result in revocation of any existing credit terms. 4. NSF payments will be subject to a $30.00 service fee. 5. NSF payments must be re-paid, including service fee, before delivery service will resume. 6. We will not accept a check or electronic payment drawn from the same account for repayment of an NSF. 7. Company personnel are not permitted to hold checks for deposit at a later date. 8. Company personnel may not accept two party checks. 9. Violation of Wisconsin Statute 125.33 (7) may result in review of credit terms. Excerpt from Wisconsin Statute 125.33 (7): (7) RETAIL PURCHASE CREDIT RESTRICTIONS. (a) Restrictions on sales. 1. No fermented malt beverages retail licensee or permittee may: a. Receive, purchase or acquire fermented malt beverages from any licensee except for cash or credit for a period of not more than 15 days. b. Receive, purchase or acquire fermented malt beverages from any licensee or permittee if at the time of the receipt, purchase or acquisition he or she is indebted to any licensee or permittee for fermented malt beverages received, purchased, acquired or delivered more than 15 days earlier. 2. No campus or fermented malt beverage retail licensee or permittee may receive any fermented malt beverages on consignment or on any basis other than a bona fide sale. (b) Restrictions on issuance of licenses and permits. No Class "A" or Class "B" license or permit may be issued to a person having an indebtedness for fermented malt beverages outstanding for more than 15 days. In each application for a Class "A" or Class "B" license or permit, the applicant shall state whether he or she has indebtedness for fermented malt beverages to any licensee or permittee which has been outstanding for more than 15 days." 10. Changes to credit terms may be applied for by submitting an updated general credit application that can be obtained through your Wisconsin Distributors Sales Representative. We reserve the right to: - - Request cash or cash equivalent - - Establish credit terms Note: Sales representatives are responsible for complying with this credit policy. Please do not ask them for special consideration. Please direct your questions to our Accounts Receivable department.
DELIVERY SIGNATURE
I agree with statement below
*
YES
NO
At times it is not possible for someone to be present when delivery of product is made. In these situations either a door is left unlocked or a key is given to the salesman. The invoice is marked charged but left without a signature. If any discrepancies are found we will contact WDI LLC, hereinafter called Wisconsin Distributors within 48 hours of delivery. If Wisconsin Distributors does not hear from us within 48 hours of delivery they can assume the delivery has been accepted as invoiced and will be paid in full within our credit terms.
PERSONAL GUARANTEE
I agree with statement below
*
YES
NO
GUARANTEE given by the undersigned shareholders, directors and/or officers, a corporation incorporated under the laws of the State of Wisconsin, hereinafter called the Corporation, to WDI LLC, hereinafter called Wisconsin Distributors. WHEREAS the Corporation contemplates incurring indebtedness in the future of Wisconsin Distributors and WHEREAS the undersigned, who are either shareholders, directors and/or officers of the Corporation, believe it in their best interest and the best interests of the Corporation to guarantee the future indebtedness of the Corporation to Wisconsin Distributors. IT IS THEREFORE AGREED, the undersigned hereby jointly and severally guarantee the payment of all indebtedness of the Corporation, where heretofore of hereafter incurred, and whether or not the Corporation is presently indebted to Wisconsin Distributors. In the event the Corporation fails to pay any amount due within 30 days after demand, the undersigned jointly and severally agree to pay in full such amount to Wisconsin Distributors upon demand. This instrument is intended to cover any indebtedness or liability presently owing or hereinafter incurred by the Corporation, or any extension or renewal thereof.
Your Name
*
Please include your name for follow-up purposes.
Your Email
*
Please include your email for follow-up purposes.
EFT Payment Info
*
Wisconsin Distributors (WDI LLC) would like to take this opportunity to offer Electronic Funds Transfer (EFT) as a payment collection option at no additional cost to you. If you like information, enter email address
Yes, please send me more Information
No, I am not interested at this time.
Your Signature
Signature
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