Agreement Form

CUSTOMER AGREEMENT FORM
PLEASE READ CAREFULLY!!
No warranties are expressed or implied.
The Buyer accepts total responsibility for the safe, proper and legal use of all
products and according to all federal, state, and local codes, regulations, laws and
insurance requirements.
The Buyer relieves Mighty-Mite Marketing, Inc., it's Officers, suppliers and agents from
any and all liability associated with the use of all it's products.
The Buyer agrees not to alter or change products in any way.
Sales will be made ONLY to Buyers who provide proof of being 21 years of age or older;
AND have a current and valid ATF License or Permit;
OR have a current and valid local/state pyrotechnicians license/permit;
AND supply a signed photocopy of the relevant documents!
These documents will be placed on file for reference for future orders.
- All products are subject to availability and on a first come, first served basis. MMM
reserves the right to changes prices or specifications or shipping arrangements without
notice.
- Prior to shipment
payment or arrangement by approved corporate/government
purchase orders, or acceptable letter of credit must be made. All payments must be in US
dollars drawn on a US bank.
- All checks may require 7-10 banking days for clearance prior to shipment.
Do not
send cash!
- Freight must be paid prior to shipment, unless shipped freight collect. A current and
valid account number with the carrier must be provided for freight collect shipments.
- Orders are shipped ONLY to a street address.
NO PO Boxes!
- Wisconsin residents add 5% sales tax. Buyer must pay all other applicable tariffs,
duties or taxes.
I have read and understand this Agreement; and certify the Buyer's Information and the
attached documents to be true and correct; AND agree to all of the terms and conditions
above.
| |
|
|
|
| County |
|
State |
|
| |
|
|
|
| Date |
|
Buyer's
Signature |
|
CUSTOMER AGREEMENT FORM
Return to: Mighty-Mite Marketing, Inc. 122 17th St S, La Crosse, WI
54601 USA
| |
|
|
| Date |
Federal
Employer ID # or Social Security # |
Date of Birth |
| |
|
| Name
|
TITLE
|
| |
|
| Company Name
and D/B/A |
PHONE 1 |
| |
|
| ADDRESS (Mailing
address) |
PHONE 2 |
| |
|
|
|
| CITY
|
ST/PROV
|
ZIP/CODE |
FAX |
| |
|
| ADDRESS [If
different than above] (Street address) |
E-Mail |
| |
|
|
|
| CITY
|
ST/PROV
|
ZIP/CODE |
WWW |
Please fill in and supply copies of either: 1 AND 2 OR 3
1A Proof of Age
| |
|
|
| Driver's License or Photo
ID# |
State |
Expiration Date |
2 ATF License or Permit
| |
|
|
| ATF License or Permit #
|
Type |
Exp Date |
3 State or local License or Permit
| |
|
|
|
| License or Permit #
|
City/State |
Type |
Exp Date |
Please complete the appropriate section; then sign other side and
return!

© April 1996, Mighty-Mite Marketing, Inc., Green Bay, WI USA. All rights reserved
worldwide.
Revised December 19, 2008