Wholesale Account Application

IMPORTANT: Wholesale accounts are only offered if you:

- Are a licensed gas contractor, gas service company, or appliance repair company.

- Can provide a valid business license.

If you would like your account to be set up using a credit card instead of billing, please fill out the application below but leave the "Credit References" section blank. Once submitted, call us at (800)334-5886 and we will store your card number on your new account.

WHOLESALE ACCOUNT APPLICATION

* Company Name

* Business License #

Billing Address

* Street Address

* City

* State

* Zip

* Country

Shipping Address

Same as Billing Address

* Street Address

* City

* State

* Zip

* Country

Contact Information

* First Name

* Last Name

* Email

* Phone

Fax

NC State Resale Tax ID

*** If you would prefer a credit card account, please call us at (800) 334-5886 once this form is submitted to complete the application process. If a billing account is preferred, please fill out the section below before submitting your application. ***

Credit Reference #1

Street Address

City

State

Zip

Country

Credit Reference #2

Street Address

City

State

Zip

Country

Your Name

First Name

Last Name

By checking these boxes, I acknowledge that:

I understand I am purchasing parts from Controls, Inc. which may be hazardous if improperly installed. Any parts that I purchase from Controls, Inc. will be installed by a licensed professional.

I agree not to hold Controls, Inc. or any of its associates liable for any losses or damages resulting from improper installation or failure of parts. Controls, Inc. is not the manufacturer of any of the parts it sells. Any and all loss or damage liability claims must be pursued through the item's manufacturer.

I have read and agree to Controls Inc.'s Warranty & Returns Policy.