OLIVIA RIEGEL

Thank you for your interest in becoming an OLIVIA RIEGEL retailer!

Either fill out the form below (you must attach a scan of your state issued Tax Certificate),
or fax the information (listed below) with your Tax Certificate to (817) 861-1115.
We will check for conflicting accounts in your area & email a catalog.

Acceptable formats for Tax Certificate are PDF, JPG & PNG.
Maximum filesize is 2 megabytes.

	Company Name:
	Phone:
	Fax:
	E-Mail:
	Tax Certificate: