Here's How It Works Fill out and hand in this application to a Cash & Carry associate and you'll get your Cash & Carry Card on the spot! Bring a copy of your resellers permit or tax id number along with this application. This is required to complete to the application. Use your Cash & Carry Card each time you shop.

To be filled out by store employee only Cash & Carry Card Number   Store # Today's Date

Business, Government Agency  [if applying for a business card]  Buying for Resale? Yes No

Non-Profit Organization Tax ID#

Business, Organization Name

Contact Title

First Name Last Name

Mailing Address City

State Zipcode County

E-mail   Phone Number

The undersigned certifies he/she/they hold a valid UBI/Revenue Registration/Retail Certificate No. Expires on.

Permit No. Expires on. Beverage No. Expires on.

Cigarette No. Expires on. Tobacco No. Expires on.

Is issued pursuant to all the applicable. Sales and Use Tax Laws; that the tangible personal property described herein which I shall purchase from Cash & carry will be resold in the form of tangible personal property; 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 in the regular course of business, it is understood that i am required by the Sales and Use Laws to report and pay tax measured by the purchase price of such property. Description of products to be purchased for resale: (check appropriate boxes)

Restaurant Supplies  Beverages[Non-Alc] Institutional Foods Packaging Stationary

Candy/Snacks  Janitorial Pet Supplies Retail[Charcoal, Fluid, Jars]

Tobacco  Pesticides Retail Paper Auto/Hardware Film/Batteries

Ice/Ice Cream, Novelties  Lights HABA

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