Become a Dealer

Do not fill this out

General Information Business Name * D/B/A * Phone Number * Fax Number Email Address * Website Cell Phone Number Federal Tax ID * Sales Tax ID * Hours of Operation Ownership

Billing Address Street Address * City * State * Zip Code *

Shipping Address Same as Billing Address Street Address City State Zip Code

Names of Officers President / CEO / Owner * Direct Phone No. * Purchasing Manager / Authorizing Entity Direct Phone No.

Dealer Account Setup

Use your email address and create a password now. After approval, you can log in with either your email address or assigned customer ID.

Password * Confirm Password *

Attachments

Please attach store registration and EIN number. Maximum attachment size per file is 5MB.

Picture of store registration * Picture of EIN number *

I/we authorize Lava Furniture Industries, Inc. to investigate financial responsibility and creditworthiness as needed for wholesale dealer approval.