Ecommerce Information

Automated Inventory File *

Daily
Weekly

Email Address to Receive Inventory File *

Business Website *

Are you part of a buying group? *

Name of Buying Group? *

Are you an authorized Tempur-Pedic dealer? *

If yes, you will also be authorized to sell our Stearns & Foster Collection

Transportation Type *

Prepaid
Collect
Pickup

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Terms

Terms Requested *

Principle Information

Owner *

Buyer Name *

Buyer Email *

Buyer Phone # *

Email to receive order acknowledgements *

Accounts Payable Contact *

Accounts Payable Email *

Shipping/Receiving Email *

Trade References

Reference 1 - Company Name *

Reference 1 - Contact Name *

Reference 1 - Phone # *

Reference 2 - Company Name *

Reference 2 - Contact Name *

Reference 2 - Phone # *

The undersigned certifies the above information to be true and correct. The undersigned agrees to respect the sales terms and conditions of Primo International. Milberg Factors is authorized to obtain or exchange any personal information as it may require, with any personal information agent or credit granter with whom the undersigned has financial relations, towards establishing or verifying his financial standing.

Title *

Date

Signature of Applicant

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Dealer Onboarding Form Complete!

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