WHOLESALE ORDERS ‘BILL-ME’ APPROVAL This Pre-Approval Form is for STORES who are requesting to re-sell SafetyCaps and who would like to be billed for their orders. Here is how the ‘Bill-Me’ Order Process Works: 1) Complete Pre-Approval Form; 2) Receive Approval and Order Form via email; 3) Complete Order Form; 4) Email Completed Form to george@safetycaps.com; 5) Receive SafetyCaps (usually within 2 weeks); 6) Receive Bill/Invoice via Email; 7) Please pay Bill/Invoice within 30 days! PRE-APPROVAL INFORMATION Billing Information: Company Name: Contact Name: Billing Address: Address (cont’d): City, State & Zip: Phone Number & Email: Shipping Information: Company Name: Contact Name: Billing Address: Address (cont’d): City, State & Zip: Phone Number & Email: For questions or concerns, please contact SafetyCaps at george@safetycaps.com Or Call (802) 849-9090 for more information and answers.