Bedding, Upholstered Furniture & Stuffed Toys Annual License Application Form (Page 2 of 2) in pdf

IMPORTANT NOTICE: It is mandatory that you complete all areas of this application pertaining to your business.

If you are a manufacturer and sending product directly into Ohio please complete Sections 1 and 3.

If you are a manufacturer but do not send product directly into Ohio please complete Sections 1, 3 and 4.

If you are an importer, distributor or wholesaler (directly bring products into Ohio) and not the manufacturer, complete Sections 1, 2 & 3.

NOTE: Both the manufacturer, importer/distributor or wholesaler must be registered in Ohio.

1. Does your company manufacture the products sold or offered for sale in Ohio? Yes______ No______

IF YES: As the manufacturer, you shall retain records of the following information for a period of not less than two (2) years

from the date they are initially offered for sale in Ohio.

A.) Specification of the articles, by individual product, manufactured, sold, delivered for sale, offered for sale, consigned, or

used as promotion or gift in Ohio.

B.) The total number of articles made available for sale, gift or promotion in Ohio.

C.) The name, address, telephone number/e-mail address of any importer or wholesaler of your products that offers for sale,

consigns, or uses as a promotion or gift in Ohio.

2. IF NO, please provide the name, address, phone number, contact person and registration number of the manufacturer.

Reg. No.

3. Does your company send products directly into the State of Ohio? Yes______

No_______

IF YES, your company will be responsible for paying the four cent per item Annual fee. A separate invoice will be issued.

If you are the manufacturer, importer/distributor or wholesaler that is sending product directly into Ohio you shall retain records of the

following information for a period of not less than two (2) years from the date they are initially offered for sale, sold, consigned, or

used as promotion or gift in Ohio.

A.) Specification of the articles, by individual product, manufactured, imported, delivered for sale, offered for sale, consigned, or used

as promotion or gift in Ohio.

B.) The total number of articles purchased from the manufacturer, if you are an importer or wholesaler.

C.) The total number of articles imported, delivered for sale, consigned, or used as promotion or gift in Ohio.

D.) The name, address, telephone number/e-mail address of the manufacturer of the products, if you are an importer or wholesaler.

4. IF NO, please provide the name, address, phone number and contact person of the importer/distributor or wholesaler that

will be sending your products into Ohio. ( NOTE: Both the manufacturer, importer/ dist. or wholesaler must be registered in Ohio)

PLEASE TYPE OR PRINT

Name and title

Signature

Date

Check number

INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. ALL SUBMISSIONS MUST BE PREPAID.

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Bedding, Upholstered Furniture & Stuffed Toys Annual License Application Form Page 2