Tri-Vin Wines And Spirits

Current and Prior Accounts DO NOT Need to Fill Out This Form

Please contact [email protected] with questions

New Account Application

Federal Tax ID Number *

License Name *

DBA / Location Name *

License Number *

Please type the number as it appears on the license

License Issue Date *

Please enter date as MM/DD/YYYY

License Expiration Date *

Please enter date as MM/DD/YYYY

Street Address *

City *

State *

Zip *

Location Phone Number *

Cellphone Number

Email Address *

Delivery Instructions *

Bank information

Bank Name *

Bank Account# *

Address *

Phone number *

Fax Number

Trade References

Name *

Phone Number *

Name

Phone Number

Name

Phone Number

Upload Files

Upload Tax ID *

Please upload IRS Letter with EIN Number

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Upload Voided Check

Please upload check with the word "VOID" written on the front

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Upload Liquor License *

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Other files

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This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Enter the sum of 2 + 8. *

By submitting this form you agree to the following.

Hereafter known as the buyer, in consideration of obtaining purchases on credit from Tri-Vin Imports, Inc. D/B/A Tri-Vin Wines and Spirits ("Tri-Vin"), 2 Clinton Pl. New Rochelle, NY 10801 (914-664-3155) hereinafter known as the seller, does hereby agree to the following: buyer agrees to honor all terms and conditions of most current price list, and assumes all responsibility for attainment of said information. Buyer also agrees to pay for interest at 1 1/2 % per month on any invoice that remains unpaid for more than 35 days after it is due, from the due date, and for any and all deliveries under and pursuant to its accounts whether ordered by the customer or by any person representing himself/herself/itself to be an agent, employee or representative of the customer. The below signed agrees to personally guarantee all indebtedness owed to Tri-Vin by the buyer. This guarantee shall be construed as an absolute and unconditional guarantee of payment, without regard to the validity, regularity or enforceability of any obligation of buyer. Creditor shall have its remedy under this guarantee without being obligated to resort first to any security or to any other remedy or remedies to enforce the payment or collection of the said liabilities and may pursue all or any of its remedies at one time or at different times. If this application is executed by a corporation, it includes any and all successor in interest of said corporation and is binding on the same and all successors in interest, now and in the future. In the event of any delinquency of any account, buyer agrees to pay all collection costs, attorney fees of 25% of the unpaid balance due, and court costs in the collection of said account. Buyer consents to the venue and jurisdiction of any court located in Westchester County, NY. Buyer agrees that in the event the buyer issues a check which does not clear the collection process, a $35.00 fee shall be added to the buyer’s indebtedness.