Burmax New Account Application

To proceed with the application, please select your business category:

Business Contact Information
Company Name*
Phone*	Fax	E-mail*
Address*	Address 2
City*	State*	Zip*
Date Business Commenced
Type of Business	If Other
Title or Position	If Other

Requirements For Opening a New Account
The following documents are needed in order to open an account with Burmax in PDF, DOC, DOCX, or JPG Format, each with a file size under 3mb. Please upload a copy of each below. Business License Resale Tax Certificate Purchase Order* New Accounts can only be opened at the time of the first order. Minimum order $100. For Board of Education and Vocational Schools, please include Resale Tax Certificate* or an Exempt Certificate. You may also mail/fax your documents to our main office: The Burmax Company 28 Barretts Avenue Holtsville NY 11742 Phone: 1-800-645-5118 Fax: 631-289-7590
Your Name*	Title
Signature
BY TYPING MY NAME BELOW, I CONFIRM THE INFORMATION PROVIDED IS ACCURATE