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New Customer Application

Please fill out this form. Fields mark with an * are required.

Important: After completing this form you must fax, email, or mail a copy of the following information.
  • Vendors License - annual license issued by your state authorizing you to resell goods and services.
  • State Registration Certificate - certificate issued by your state to acknowledge you will be conducting business in that state.  Only your main home state is required unless you are requesting an account for each branch.
Company Information
Company Name *:  
Street Address *:  
City/Providence *:  
State *:  
Zip *:  
Country *:  
Phone *:  
Fax:
Email Address:
Web site Address:
Type of Entity *:  
Primary Contact
Name *:  
Title *:  
Phone *:  
Email Address:
Street Address:
(if different than above) 
City/Providence:
State:
Zip:
Country:
Terms and Conditions

Completing and submitting this form does not guarantee acceptance by Handley House, Inc. All applications are subject to review and additional information may be requested. New customers will be required to have a credit card on file in order to place orders. An open account may be requested after six months. Acceptance as a customer by another distributor or former distributor in the same industry as Handley House, Inc. does not guarantee acceptance by Handley House, Inc.

Applicant understands that if accepted as a customer of Handley House all orders will be subject to acceptance at its home office, 2 Forth Street, Wheeling, WV 26003, and at all terms and conditions current at the time of order acceptance. Prices, terms and special discounts may be changed without prior notice to the customer. Discounts are allowed only if an account is in current status. Products, prices, and descriptions may not be 100% accurate as listed on www.handleyhouse.com nor in any published media by Handley House, Inc.

Applicant further agrees that if accepted as an account all orders will be deemed to have been entered into in Ohio County, West Virginia, and shall be interpreted in accordance with the laws of the State of West Virginia. Applicant understands that payment is due according to terms and discounts stated on each invoice and that discounts are allowed only if payment is postmarked on or before due date indicated on the invoice.

Applicant agrees that any past due balances will be subject to interest charges determined by Handley House, Inc. as listed on each invoice. Account balances over 180 days old will be turned over to a collection agency. Applicant agrees to pay actual costs of collection including attorney fees and court costs. Applicant also agrees that in the event any portion of an open account becomes delinquent any and all invoices on the account, including future dated invoices shall become due and payable immediately and all future orders and shipments will be held until balance is paid in full.

Applicant agrees to notify Handley House in writing within thirty days of any changes in physical location, primary contact, ownership, and business licenses and registrations. Handley House, Inc. is not responsible for returned shipments due to inaccurate information. Applicant agrees that all customers of Handley House, Inc. are subject to annual reviews and may be requested to update the information provided above. Failure to comply will result in credit hold and all future orders and shipments will be stopped. Applicant agrees that Handley House, Inc. may terminate any account at any given time and in any status without prior notice.

I accept the terms and conditions above and agree that the information provided in this application is correct and accurate.