PRINT Wholesaler Application Form

Please print and sign the following documents and fax it to us at 626-810-3231 along with your business license and driver license.

Ceri International Corporation
18541 Gale Ave., City of Industry, CA 91748
Tel: 626-810-3283
Fax: 626-810-3231

By signing this agreement and the wholesale buyer's company certifies that the company is in the business of reselling merchandise and have provided proper business and resell license information to Ceri International Corp. The wholesale buyer's company acknowledges and agrees to the terms and policy set forth in Ceri International Corporation's wholesale agreement. The wholesale policy is available for review at

http://www.ceriwholesale.com/s.nl/sc.7/category.-107/it.I/id.27/.f

Wholesale Buyer's Company 

Your Order Number: _______________________________________________

Contact Name:____________________________________________________

Title_____________________________________________________________

Company Name: :__________________________________________________

Phone Number: ____________________________________________________

Fax Number: ______________________________________________________

E-Mail: ___________________________________________________________

Seller’s Permit # (Require if you are located in California in order for us to waive sales tax on purchase)

_________________________________________

CREDIT CARDHOLDER AUTHORIZATION FORM

Date: _______________

I, ______________________________________________ (Name of cardholder as it appears on the credit card)

authorize Ceri International Corp,

to charge

Credit Card Type (Visa/Mastercard/American Express/Discover) ________________________________

Name on Credit card ____________________________________________________

Credit Card Number _____________________________________________________

Expiration Date _________________________________________________________

CVV Code (3 Digits on the back of Visa/Mastercard/Discover Card or the 4 Digits on the front of the American Express Card) __________________________________________________

for wholesale purchases placed with Ceri International Corporation. 

Note:

1.. Please provide the 800 customer service number on the back of your card 
2.. Please provide the address that matches with the credit card monthly statement below. 
3.. Sign and fax this form along with a copy of your driver license to 626-810-3231 . 

800 Customer service # _________________________

Billing Address: ___________________________________________________

City ________________ State: ________ Zip: _____________

By signing below, I authorize Ceri International Corp to charge my credit card for payment for my wholesale purchases. This authorization will remain in effect until the business relationship is terminated with a formal written request. 


Authorized Signature

Sign By ________________________________ 

Print Name:_____________________________

Date: __________________________________

PRINT Wholesaler Application Form