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

Hidden

Terms

Terms Requested *

Terms Amount ($) *

Credit Card Authorization Form

Please complete the credit card authorization form in full.

Card Type *

Credit Card # *

Expiry Date *

Card Verification CVV *

Found on back of card

I authorize Primo International to keep my credit card on file as a method of payment for all orders. I confirm that I am the rightful owner of the card and authorize the processing of my card for payment purposes. I understand that all transactions will be subject to the terms and conditions of Primo International.

I agree to the above terms. *

Principle Information

Owner *

Buyer Name *

Buyer Email *

Buyer Phone # *

Email to receive order acknowledgements *

Accounts Payable Contact *

Accounts Payable Email *

Shipping/Receiving Email *

Financial Information

Bank *

Bank Contact Name *

Bank Account # *

Bank Address

Bank Phone # *

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

Clear

Dealer Onboarding Form Complete!

We’ve received your dealer application and will review it shortly. Our team will be in touch soon with the next steps. If you have any questions in the meantime, please feel free to reach out.

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