PPD

60 Galli Drive, Suite #1 Novato, CA 94949

p 415.883.1888 f 415.883.1999

CATALOG REQUEST FORM
 
Thank you for your interest in PPD.
 
In order to process your catalog request, we will need the following information from you:
   
Company Name:
Contact Name:
Street Address:
City:
State:
Zip:
Phone: (xxx) xxx-xxxx
Fax: (xxx) xxx-xxxx
Email:
Website:
   
   
Please fill in the following information:  
   
Type of business:
# of years in business:
Are you an online reseller? Yes No , If Yes website?
Are you an interior designer? Yes No
Do you have a wholesale business? Yes No
   
Please complete the following Blanket Certificate of Resale:  
 

Blanket Certificate of Resale
 
Name of Purchaser:       Address of Purchaser:
 
I hereby certify: that I hold a valid seller's permit No.  issued pursuant to the Sales and Use Tax Law; that I am engaged in the business
of selling: ; that the tangible personal property described herein which I shall purchase from
PPD will be resold by me in the form of tangible personal property; provided, however, that in the event of such property is used for any purpose other than retention,
demonstration, or display while holding it for sale in the regular course of business, it is understood that I am required by the Sales and Use Tax Law to report and pay tax,
measured by the purchase price of such property or other authorized amount.
 
Description of property to be purchased:
By checking this box you accept it as a substitute for the Signature of Purchaser or Authorized Agent      Date: (mm/dd/yr)
Printed Name/Title:       Telephone #: (xxx) xxx-xxxx
 
Please click the submit button to send your completed form.