Company Members

Name *

Title *

Name

Title

Name

Title

Name

Title

Attachments

Attach files below: *

Please attach documentation for one of the following: - Proof of current ASID Membership - Resale or Sales Tax Certificate copy - Business ID Number - Interior design certification - W9, Federal ID form, or EIN Number - Current Business License in Design-based business

For Illinois businesses only:

Should Tower Lighting charge you Sales Tax?

If you intend to purchase merchandise for resale, you will be required to supply a Resale or Sales Tax Certificate. Without this documentation, sales tax will be applied to all orders.

Online payments may be subject to a credit card processing fee. I understand I can choose to pay by check to avoid this fee. *

I agree

I have read and understand the Terms of Sale set forth for the purchase of lighting fixtures from Tower Lighting (https://towerlighting.com/pages/terms-and-conditions). *

I agree

Signature

DISCLAIMER: By typing your name below, you are signing this application electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this application.

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Have a great day!

Thanks for getting in touch!

We appreciate you contacting us. One of our colleagues will get back in touch with you soon!

Have a great day!

Trade Account Information

Company Information

Company Members

Attachments

For Illinois businesses only:

Thanks for getting in touch!

Thanks for getting in touch!

C141 Retrò Black & White Wall Mount