PBR Wholesale Partner Application

Name *

Email Address *

Business Name *

Business Type *

Position / Title *

Business Address

Street *

City *

State *

Zip *

Annual Sales Revenue *

Sales Channel(s) *
Brick n Mortar
E-commerce
Both

Required Documents

FFL License * (.pdf, .jpg, .png)

State Business License * (.pdf, .jpg, .png)

Sales and Use Tax Exemption Certificate * (.pdf, .jpg, .png)

SOT (Optional)