Credit Application | Wine Country Gift Baskets

Gift Baskets
Gift Baskets
Sign In
amazon sign-in facebook sign-in google sign-in yahoo sign-in twitter sign-in
Wine Country Gift Baskets Chat
Internet Specials
Shop by Occasion
Shop by Gift Type
Shop by Price
Free Catalog
Can I ship wine to?
Receive exclusive offers by email
Follow us on:
Credit Application
We welcome your interest in doing business with our company! All information submitted will be held in strictest confidence
and used solely for reference purposes within our credit department. It will take about 3 ~ 5 days to response your inquiry.


* indicates the required field.
* Amount of credit requested $: (Minimum $1500)
DUNS/Tax ID #:
1. TELL US ABOUT YOUR COMPANY: * indicates the required field.
* Is Your Organization Sales Tax Exempt? Yes No
* Is a Purchase Order Required? Yes No
* Full Legal Name/Business Entity:
* Doing Business As:
* Business Address Phone #: Fax #:
Address Line 1:
Address Line 2:
State: Zip:
Mailing Address: Phone #: Fax #:
(if Different) Address Line 1:
Address Line 2:
State: Zip:
2, ACCOUNT INFORMATION: * indicates the required field.
* Name of Main Contact: * Email Address:
* Phone #: Fax #:
* Authorized Purchasers: 1: 2:
3: 4:
5: 6:
Accounts Payable Contacts: 1: 2:
3: 4:
5: 6:
I authorize Wine County Gift Baskets, 4225 N. Palm Street, Fullerton, CA 92835-1045 to receive full information as requested
relating to our credit experiences. Wine Country Gift Baskets reserves the right to request any additional information as
pertaining to your credit history. I affirm that all information provided is correct.

By typing your name below, You agree that this is valid as your signature.


You understand that all purchases will require authorization. If your account balance is delinquent or in default, we may not authorize a purchase and we, at our discretion, may cancel your account.

Terms are net 30 days from date of shipment. Freight terms are F.O.B. Fullerton unless delivered by UPS/FedEx.

Order TotalTotal Discount
$4,000 - $7,99910%
$8,000 - $11,99912%
$12,000 +15%

We will charge you a returned check charge of $20.00 for each check that is returned unpaid.

The use of your account by you or anyone whom you authorize or permit to use your account means you accept this agreement. You agree to pay in U.S. dollars for all purchases, including applicable finance charges and other late fees and charges, incurred by you or anyone you authorize or permit to use your account, even if you do not notify us that others are using your account. All checks must be drawn on funds on deposit in the U.S.
Cybertrust Certified Logo;
Copyright 2015 Wine Country Gift Baskets - Wine Country Gift Baskets® and
Wine Country® are registered trademarks-All rights reserved. (800) 394-0394
  Terms of Use - Privacy Policy - Employment - About Us - Site Map - Press Release