New Customer Application FormPlease enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Company InformationLayoutCompany Name *DBA *Busienss StructureCorporationLLCPartnershipSole ProprietorBusiness TypeRestaurantRetailChainHotel / ResortWebsite / URLLocation Phone Number *Buyer Full Name *Buyer Phone Number *Buyer Email Address *AP Full Name *AP Phone Number *AP Email Address *Delivery DaysMondayTuesdayWednesdayThursdayFridaySaturdaySundayReceiving Hours (From:)Receiving Hours (To:)CA Reseller's Permit Number *CA ABC License NumberProvide a copy of Reseller's Permit & ABC License documents Click or drag a file to this area to upload. Delivery Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePersonal GuaranteeFull names of owner, partner or corporate officerOwner 1Full Name *Job Title *DOBDrivers License NumberSignatureClear SignatureI personally and unconditionally guarantee payment of all indebtedness of the above account and agree to be bound by the below terms and conditions as set forth below. This guarantee shall remain in full force until cancelled, by Certified Mail Return Receipt Requested, and forwarded to ITINC Group credit department.Date *Credit Terms and ConditionsCheckboxes *I hereby authorize ITINC Group to conduct a credit check and verify the above-mentioned information.I hereby certify that I hold a valid seller's permit, listed above, and is issued pursuant to the Sales and Use Tax Law.I hereby certify that I hold a valid ABC alcohol license, listed above, and is issued pursuant to the CA Alcohol Beverage Control legal requirements for the product purchased.I hereby certify that I am engaged in the business of alcoholic & non-alcoholic products, spirts, and mixers that contain the tangible property described herein which I shall purchase from ITINC Group, and will be sold by me in the form of tangible personal property; PROVIDED, however, that in the event of 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 Tax Law to report and pay for the tax, measured by the purchase price of such property. Description of property to be purchased: Beer, Wine, Spirits, and/or Sweeteners.Applicant's Signature *Clear SignatureFor purpose of obtaining merchandise from ITINC Group, statements in writing here are made knowing that ITINC Group is relying upon same, should credit be extended. It is understood that the information as supplied is confidential and shall be regarded as continuous until cancelled by the customer in writing, via Certified Mail, to ITINC Group credit department. Further, purchaser shall notify ITINC Group, via Certified Mail, of any change of ownership, at least 10 days prior to the effective date of said change. The undersigned agrees that the foregoing information is true and accurate and agrees to neither order nor accept goods from ITINC Group while insolvent within the meaning of Uniform Commercial Code Section ("UCC") 1201 (23). Every order placed, or delivery accepted, while customer is insolvent shall constitute a written misrepresentation of solvency to the seller within the meaning of UCC Section 2702 (2). And to pay, when due, all invoices from ITINC Group, and any invoice past due is subject to a 1-1/2 percent per month (1.5 %) Finance Charge. Further, I/we hereby authorize any of the banks, trade references or agents of ITINC Group to provide all information requested and authorize them to obtain credit reports on the applicants), principal(s), or its guarantors from sources of its choice and whenever it chooses, at its sole discretion. In the event of any litigation arising out of this agreement or it is necessary to commence collection proceedings, the selling party shall be entitled to their costs and expenses incurred, including attorney fees and collection fees.Date *Submit Don't Be ShyIf we didn’t answer all of your questions, feel free to drop us a line anytime. Get In Touch