New Account Application Excited to work with you! To get started, please complete this form Account Contact InformationDBA NameDBA NameField is required!Field is required!Account's Physical AddressAddressAccount AddressField is required!Field is required!CityAccount CityField is required!Field is required!State- select a state -AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming- select a state -Field is required!Field is required!ZipcodeAccount ZipcodeField is required!Field is required!By clicking this box - you are authorizing permission to be signed up for the online payment option and weekly text/email new product communicationsField is required!Field is required!Primary Contact InformationNameNameField is required!Field is required!EmailYour E-mail AddressField is required!Field is required!CellYour Phone numberInvalid phonenumber!Invalid phonenumber!The Primary Contact is also the:(select all that apply)OwnerBuyerAccounts Payable ContactField is required!Field is required!License NameLicense NameField is required!Field is required!CABC License #CABC License #Field is required!Field is required!Tell us a little more about your businessType of business?Type of business?Field is required!Field is required!Hours of operation?Hours of operation?Field is required!Field is required!Preferred Delivery DaysPreferred Delivery DaysField is required!Field is required!Preferred Delivery HoursPreferred Delivery HoursField is required!Field is required!Is account seasonal?YesNoField is required!Field is required!Alcohol consumed on premise?YesNoField is required!Field is required!Chain?YesNoField is required!Field is required!This account carries:(select all that apply)DraughtPackageField is required!Field is required!Special instructions for delivery?(Front door, back door, side door?) Special instructions for delivery?Field is required!Field is required!Billing InformationBilling AddressBilling AddressField is required!Field is required!CityBilling CityField is required!Field is required!State- select a state -AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming- select a state -Field is required!Field is required!Zip CodeBilling ZipcodeField is required!Field is required!Federal Tax Identification #Federal Tax Identification NumberField is required!Field is required!Reseller Permit #Reseller Permit #Field is required!Field is required!Terms & ConditionsI hereby certify that the information contained herein is complete and accurate, and the person executing this agreement has authority to bind the retailer and is authorized by the retailer to enter into transactions with RLED, LLC. Further, I certify that my the following are valid and in good standing: CABC alcohol license, reseller permit/tax exempt status, and business entity status with the Secretary of State of California. Finally, this information has been furnished with the understanding that it is to be used to determine the amount and conditions of the credit terms to be extended. All credit terms will be in compliance with state alcohol laws and regulations. The undersigned understands that RLED LLC dba Bar Beverages must be notified in writing by certified mail of any change in ownership, the name or business structure under which credit is established. The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, national original, sex, marital status, age, (provided the applicant has the capacity to enter into a binding contract), because all or part of the applicants income derives from any public assistance program, or because the applicant has in good faith exercised any right under the consumer credit protection act to the extent is would apply.I hereby certify that the information contained herein is complete and accurate, and the person executing this agreement has authority to bind the retailer and is authorized by the retailer to enter into transactions with RLED, LLC. Further, I certify that my the following are valid and in good standing: CABC alcohol license, reseller permit/tax exempt status, and business entity status with the Secretary of State of California. Finally, this information has been furnished with the understanding that it is to be used to determine the amount and conditions of the credit terms to be extended. All credit terms will be in compliance with state alcohol laws and regulations. The undersigned understands that RLED LLC dba Bar Beverages must be notified in writing by certified mail of any change in ownership, the name or business structure under which credit is established. The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, national original, sex, marital status, age, (provided the applicant has the capacity to enter into a binding contract), because all or part of the applicants income derives from any public assistance program, or because the applicant has in good faith exercised any right under the consumer credit protection act to the extent is would apply.I hereby certify that the information contained herein is complete and accurate, and the person executing this agreement has authority to bind the retailer and is authorized by the retailer to enter into transactions with RLED, LLC. Further, I certify that my the following are valid and in good standing: CABC alcohol license, reseller permit/tax exempt status, and business entity status with the Secretary of State of California. Finally, this information has been furnished with the understanding that it is to be used to determine the amount and conditions of the credit terms to be extended. All credit terms will be in compliance with state alcohol laws and regulations. The undersigned understands that RLED LLC dba Bar Beverages must be notified in writing by certified mail of any change in ownership, the name or business structure under which credit is established. The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, national original, sex, marital status, age, (provided the applicant has the capacity to enter into a binding contract), because all or part of the applicants income derives from any public assistance program, or because the applicant has in good faith exercised any right under the consumer credit protection act to the extent is would apply.Field is required!Field is required!By clicking the submit button, I agree to the terms & conditions. Field is required!Field is required!Field is required!Field is required!Submit