Become a Dealer

Complete the form below to register as a new dealer. Your registration will be pending approval.

Company Name *

Store Name *

Buyer's Assistant *

Business Type *

Store
Online
Designer Rental

Applying for

Email *

Tax ID *

Resale Licence # *

Name *

Address *

City *

State *

Zip *

Bill To Information

Bill To *

Address *

Tel *

Ext *

Fax *

Email *

Company Website *

Ship To Information

Copy Bill To to Ship To

Ship To *

Address *

Tel *

Ext *

Fax *

Email *

Contact Name *

Resale Certificate *

Please upload here your resale certificate in PDF format.

File name:

File size:

One Time Credit Card Payment Authorization Form

Sign and complete this part to authorize Easy Buy International Corp / DBA Stanza
Furniture to make a one time debit to your credit card listed below. By completing this part you give us permission to debit your account for the amount indicated on or after the indicated date. This is permission for a single transaction only, and does not provide authorization for any additional unrelated debits or credits to your account.

Credit Card Authorization

Complete the credit card authorization form.

Full Name *

Date *

Enter the date when the payment will be made.

Description *

Billing Address *

City *

State *

Zip *

Phone Number *

Email *