Thank you for your interest in becoming an Etc. brand dealer. This registration is open to Dealerships within the Continental U.S. By submitting this registration, you are applying to be an Etc. Dealer and agreeing to the terms provided below and by reference. If approved, you will have access to sell only Etc. products.

Do you have an existing account with a Kimball International brand?

List Account Number:

Company Name (Legal Entity):

DBA (if applicable):

Street Address:

City:

State:

Zip Code:

Billing Address (if differs from above):

Contact Information

Dealer Principal or President:

Must be an authorized signee with your bank

Title:

Phone:

Email:

Main Point of Contact:

Phone:

Email:

Financial Services Contact:

Phone:

Email:

Sales Manager Name:

Email:

Mailing Address:

Email for Order Acknowledgements:

Email for Invoices:

Website Find a Dealer Info

Email Address:

Phone Number:

Business Hours:

Additional Information

Do you have a place to display product (designated or working showroom)?

Do you have special warehouse instructions for deliveries?

Special Warehouse Instructions:

Manufacturer Alignment:

Type of Business:

Federal ID#:

State of Incorporation:

Taxable or Non-Taxable:

Attach sales tax exception certificate for the state(s) in which you are located and a certificate for each of the following states if shipments will be made into any of these states: CA, DC, HI, MA, MD, MS, NY, LA, SD, and TN. A completed multijurisdictional form including the exemption numbers for your state and for all the above states to which you will be shipping is acceptable.

File Upload Size Limit of 25MB

Bank Reference

Bank Name:

Address:

Phone:

Secured?

Type of Security:

Trade Reference 1

Name:

Address:

Phone:

Email:

Trade Reference 2

Name:

Address:

Phone:

Email:

Trade Reference 3

Name:

Address:

Phone:

Email:

Attach W-9

File Upload Size Limit of 25MB

TERMS OF ETC. DEALERSHIP
By checking the box below, you agree to the following specific terms applicable to the Etc. Dealer relationship:

Etc. Dealers have access to Etc. brand products, and will not have access to National brand products unless specifically authorized in a separate Agreement with National Office Furniture.
You are not authorized to resell Etc. products through any online channel.
Dock delivery is required for each order and is included in the price of the product.
Registration is open only to Dealerships within the Continental U.S.
National will obtain independent credit reports and other information from applicant's listed references and banks and will use that information to determine applicant's credit-worthiness.
All invoices are required to be paid promptly and in full. Invoices paid late will be subject to monthly service charges of 1.5% per month or the maximum amount permitted by law, whichever is less.
If National has to take legal action to collect payment, all collection costs, including without limitation all actual out-of-pocket expenses and collection fees (including collection agency and attorneys' fees) incurred by National will be the sole responsibility of the Etc. dealer.
You are not authorized to represent your dealership as a National dealer. Any advertising, marketing or other materials relating to the Dealership that reference National must do so in conjunction with the Etc. brand, i.e. "Etc. by National."
National Office Furniture reserves the right to terminate any Etc. dealer at any time, at the sole discretion of National Office Furniture.

*

I agree to the Terms of Etc. Dealership listed above

*

Except to the extent modified above, I agree to National Office Furniture's Standard Terms & Conditions

*

I agree to the Code of Conduct

Name of person submitting form (you have legal authority to do so):

Email of person submitting form:

Title of person submitting form: