New Customer application form

Business Name:
C/O Name (Owner or Manager):
Business Street Address:
Zip Code:
Phone Number:
My Billing address is different:
Sales Tax #:
Tobacco License #:

In order to purchase tobacco or be tax
exempt you must provide a copy of your
Oklahoma Sales Tax and Tobacco License.

Sales Tax #: (PDF/JPEG)
Tobacco License #: (PDF/JPEG)
Newsletter Signup: yes no

Click here if you would like to print a copy

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