Hummert International: Distributor of Horticultural Products - greenhouses, chemicals, landscaping supplies, plant containers...

Thank you for completing our form. If you are requesting to become a wholesale customer and to receive the Hummert Catalog, please be sure to attach or email us a copy of your sales tax exemption certificate or federal id/business license.
Catalogs are provided free of charge to existing customers who spend a minimum of $500 per year. Catalogs are only sent to commercial businesses or schools.
If you DO NOT have an existing account with us, please verify your commercial status in the horticultural field by faxing a copy of your State Resale Tax Certificate or Business License along with a copy of your Publication request to:314-506-4510.

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Questionnaire for New Wholesale Accounts

This form is devoted to obtaining the correct and current information about our customers so that we may serve them in the best possible manner.

CATALOG REQUEST – Our catalog is sent to only the Commercial Horticulturist who is actively growing any type of plants for resale or research. Verify your commercial status in the horticultural field with a copy of your State Resale Tax Certificate or Business License.

• CUSTOMER SERVICE INFORMATION – Please complete the following.

PLEASE NOTE: This form is designed to obtain customer service information and is NOT a credit application.

* these fields are required

Mailing Address:
*Name
*Company		Customer No.
*Address
*City		*State
*Country		*Zip code
*Telephone		*Fax
*Email address

Shipping Address: (Same as "mailing address" unless otherwise indicated)
Company
Address
City		State
Country		Zip code
Telephone		Fax
Email address
*State Tax Number (Please note: If a sales tax number is indicated, by law we must have a signed copy of our sales tax form for it to be valid.)
Pesticide Applicator/Operator Permit No. (If a pesticide permit is indicated, we must have a copy of the license on file for you to purchase restricted use chemicals.)
Federal I.D. No.
Name on Permit		Expiration Date

*Customer Business And/Or Operation
Please indicate your main business activities in order of priority from the following table, using the related code.
1st 2nd *3rd

01 - Greenhouse, Shade House, Hydroponics	07 - Garden Center, Hardware, Co-op, Building Supply	13 - Landscape Architect, Contractor	19 - Pest Control
02 - Nursery, Forestry, Arborist, Orchard, Vineyard	08 - Amusement Park, Sports Facility	14 - Hospital, Church, Horticultural Therapy	20 - Utility Company, Fed. or State Agency
03 - Commercial Vegetable, Fruit, Produce, Agricultural Farm	09 - Botanical Garden, Arboretum, Zoo, Municipal Park	15 - Penitentiary	21 - Purchasing Department
04 - School, University, Extension Service, Research	10 - Golf Course, Sod Production, Cemetery	16 - FFA, Vo-Ag	22 - Hummert Vendor
05 - Landscape Design, Maintenance, Real Estate Management Co.	11 - Hotel, Resort, Mall, Interiorscaper, Restaurant, Museum	17 - Christmas Greens/Supplies Merchant	23 - Organizations, Societies
06 - Florist, Plant and/or Gift Shop, Supermarket	12 - Irrigation and/or Lighting Installer	18 - Broker, Exporter, Forwarder	24 - Hobby Horticulturist, Master Gardener

If greenhouse or nursery, please indicate your principle crops

Greenhouse Sq. Ft. Nursery Acres

Publications
Please check those publications you wish to receive:
Horticultural Supply	Plants & Cuttings Catalog	Spring & Fall Bulb Lists	Hummert's Monthly
Christmas List	Lawn & Garden Catalog	Clearance Products List (OS, DM, DS)	No Publications

Check Here if You Would Like:
Mail Order Forms	Credit Application Download credit application	Tax Exempt Form

Would You Like a Sales Representative to Call You?
Yes Best time to call			No

Directions:
May we have the directions to your facility from the nearest interstate?
Please provide them here:

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