Wholesale – CA Blackworms.com

Wholesale application

Tell us about your business

Complete this application to request wholesale access.

Business details

Legal business name * DBA or trade name Primary contact * Business email * Phone * Tax ID / EIN *

Initial delivery location

Wholesale orders can only ship to delivery locations approved by each storefront.

Location label * Recipient or facility * Street address * Suite, unit, or building City * State / province * Postal code * Country code *

Application Documents

IRS EIN

Upload IRS EIN

State Tax Exemption *

Upload State Tax Exemption State Tax Exemption expiration date *

I confirm the information is accurate and understand that wholesale access, tax exemption, documents, and delivery locations require approval.