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Email Address

Confirm Email Address

General Info

Primary Contact

First Name

Last Name

Other Contact authorized to place order

First Name

Last Name

Company

Website

Retailer

Residential Designer

Hospitality/Contract

Billing Address

Billing Contact

First Name

Last Name

Street/PO Box

City

State/Province

Zip/Postal Code

Country

Email Address

Federal ID No.

Phone

Fax

Cell

Shipping Address

Street/PO Box

City

State/Province

Zip/Postal Code

Country

Resale Certificate

You must have a Resale Certificate to be exempt from Sales Tax in the state in which you purchase. If you plan to sell merchandise to another state, you may also be required to hold a Resale Certificate in that state. Blue Pheasant does not allow a tax exempt without a Resale Certificate

Resale Number

Resale Date

State Issues By

Expiration Date

Attachment for resale certificate

Trade References and Account Numbers

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info@bluepheasant.com
626-373-9750

For immediate assistance, please call between Monday to Friday, from 8:30am to 5:30pm PST.

Apply for an Account

Primary Contact

Other Contact authorized to place order

Billing Contact

Already an existing customer?

Already an
existing customer?