You can use the forms before or email us [email protected] Pact Act Form This form is submitting relevant documents required under the Pact Act. If you have multiple locations you would like us to ship to, please submit this form for each location. Pact Act * Required First Name Last Name Email Associated to Account Phone Number Address Address Line 2 City State / Province / Region Zip Code Country Shop Business License State Sales Tax Permit Sales Tax License / Resellers Certificate Expiration Date Tobacco License (If Required by state) Tobacco License Expiration Date Contact Billing Contact Us * Required Your Name (required) * Shop Name (required) * Email Address (required) * Phone (required) * Your Message [recaptcha] Contact Sales Contact Us * Required Your Name (required) * Shop Name (required) * Business License (required) Email Address (required) * Phone (required) * Your Message * Contact Shipping Contact Us * Required Your Name (required) * Shop Name (required) * Email Address (required) * Phone (required) * Your Message [recaptcha] Contact Webmaster Contact Us * Required Your Name (required) * Email Address (required) * Phone (required) * Your Message Error/Swap Form Error/Swap Form * Required CompanyElysian LabsEclipse CBD MGR ApprovalKatyJimJimmyVanessa Sales Representative* Order Number Store Name* Contact Person/Email Address (street,city,state,zip) Bottles to Ship (Eliquid/MG/Count)1 per line Bottles to Receive (Eliquid/MG/Count) 1 per line Production Error (Eliquid/MG/Count) 1 per line Detailed explanation of shipping error Register for Wholesale Thank you for your interest in our products. To start the process please fill out the form below and we will be in touch with you as soon as possible! Register * Required First Name * Last Name * Email * Phone Number * Address Address Line 2 City State / Province / Region Zip Code Country Shop * Business License (required) * Purchaser Name Additional Info [recaptcha]
