If you are a retailer who would like to carry our products in your store, please complete the application below.

* Store Name:		Penny Laine Papers 2211 Century Center Blvd., Suite 110 Irving, TX 75062 972. 812.3000 (phone) 800.456.6484 (toll free) 972.812.3004 (fax) 866.217.8043 (toll free fax)
* Contact:
* Address:
* City, State Zip:	Alabama Alaska Arizona Arkansas California Colorado Connecticut Deleware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Ontario Oregon Pennsylvania Puerto Rico Quebec Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
* Phone:
FAX:
Email:
* State Resale Tax No.:
* Type of Business:	Select... General Gift Store Home Business Stationery/Party Store Childrens/Toy Store Online E-tailer Other
Have sales rep. call?	Yes No
Comments or Questions:
	* = Required
Catalogs requested:	To receive a catalog you must fax or mail a COPY of your State Resale Tax CERTIFICATE to Penny Laine Papers.