1-248-887-3187

Wholesale

Weekdays 9AM - 5PM EST

Mobile Home - Manufactured Housing - RV

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Wholesale Application

Company Name:

Phone Number:

Fax Number:

Email:

Billing Address:
Name:
Street:
City, State, Zip

Shipping Address:
Name:
Street:
City, State, Zip

TAX I.D. #
Copy of current business license:

The following are employees, including the owners’ name (*) that would be authorized to make purchases and/or pick up merchandise on behalf of your company:
Employee name:

Employee name:

Employee name:

Employee name:

Employee name:

Employee name:

Employee name:

Employee name:


Add Employee Remove Employee

Credit Card information: (OPTIONAL) We accept VISA, MASTERCARD, DISCOVER cards.
Name as it appears on card:
Card number: Exp. Date: CVV code:
CC billing address:
Name:
Street:
City, State, Zip

By signing below, you give Mobile Home Depot, Inc. permission to charge the above card for purchases made by the above-named people on your behalf. This card will be kept on file until the expiration date or changes are made in writing by the cardholder or Mobile Home Depot, Inc. If a credit card is not on file, payment is due at time of purchase.
Your electronic signature constitutes your signature.

Signed: Date:

Mobile Home Depot, Inc. wholesale pricing is based on a percentage of most items. Excluding hot water heaters, furnaces, heat tape products, clearance and special priced items. This wholesale discount is being offered to YOU as a courtesy. The discount is not intended for, nor will it be giving to any individuals not mentioned on this form. If you want to make any changes to this form, you must notify our company in writing. Please sign below stating you understand and agree with the above terms for wholesale pricing.
Your electronic signature constitutes your signature

Signed: Date:

Please choose your Username and Password here. Must be ALL LOWERCASE and a minimum of 4 characters.
Username:
Password:




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