WHOLESALE APPLICATION

Please note: We are not approving new Amazon/Web retailers at this time.

Complete the application below and attach a copy of your Business License and Sales Tax Permit/Resale Certificate 

Phone: 1.888.352.0214 Option 2 or Email: wholesale@livonlabs.com



For International Inquiries: Please review our International Shipping Policy prior to completing an application to see if your country is listed under "Countries We Cannot Ship To."


* Denotes a required field

Minimum Purchase Requirements*:
Eligibility for Wholesale requires purchase of a minimum of four cases per year. Each case contains 12 cartons.
Is this a requirement your company anticipates to meet? 

Company Name* and DBA (if applicable):
Name and Phone of Owner/Partner/Officer:
Business Type:
Date Established:
(MM/DD/YY)
Pick
Billing Country*:
(see International Shipping Policy)

Billing Address Line 1:
Billing Address Line 2:
Billing City:
Billing State:
Billing Zip/Postal Code:
Primary Contact First Name*:
Primary Contact Last Name*:
Primary Contact Title:
Preferred Method of Contact:
Phone:
Alt Phone:
Fax:
Email*:
Federal Tax ID:
Describe your business*:
Do you sell products to the general public?
(hold CTRL and click to select multiple options)

Check box if you sell products within a physical location:
If selling to General Public, please provide a customer service phone number or email we are able to share:
Phone
Email
Do you sell products on eCommerce sites like Amazon.com, eBay, Jet, etc.? (check box for "yes")
If Yes, list the name(s) of each store as listed on each site:
List each address for all locations where you intend to sell LivOn products:
List each Web URL where you intend to sell LivOn products:
How did you hear about LivOn Labs?
If you selected Tradeshow above, please fill in the Tradeshow Name:
Describe Other Products You Sell

Select the marketing methods you use to promote products:
Product Demonstrations
Brochures
Posters/Displays
Email
Internet
Personal Consultation
What support tools would enhance your efforts in promoting LivOn products?
Please attach a copy of your Business License and Sales Tax Permit/Resale Certificate:
Or Fax to 702.946.0873
Failure to provide these documents will result in delays in processing your application.