Provider-Partner Application

Thank you for your interest in becoming a Bluff Country Quilting LLC Provider Partner.

This application is for funeral homes, green burial providers, cemeteries, hospice organizations, end-of-life planners, care professionals, retailers, and other qualified businesses that wish to resell or offer our handcrafted quilted burial wraps to the families they serve.

Because approved Provider Partners may purchase products for resale on a tax-exempt basis, we require current resale or sales tax exemption documentation before a wholesale or reseller account can be activated. Please complete all required fields and upload the appropriate tax-exempt or resale certificate for your business.

Submission of this application does not guarantee approval. Bluff Country Quilting LLC will review your information and contact you if additional details are needed.

We appreciate your interest in helping families find a natural, meaningful, and environmentally conscious burial option.

1. Business Information

Legal Business Name

DBA/Public Business Name,if different

Business Website

Phone

Business Address

Address Line 1

Address Line 2

City

State

Zip Code

Shipping Address, if different

Address Line 1

Address Line 2

City

State

Zip Code

2. Primary Contact

Contact

First

Last

Title/Role

Phone

Best Method of Contact

Email
Phone
Text
Mail

3. Business Background

How long has your business been operating?

Less than 1 year
1 - 3 years
4 - 10 years
More than 10 years

Briefly describe your business and the customers or families you serve.

Do you currently offer green burial, natural burial, or eco-conscious end-of-life products?

Yes
No
Planning to

Do you operate from a physical location?

Do you sell online?

Where do you intend to offer Bluff Country Quilting LLC burial wraps?

4. Products of Interest

Please indicate the burial wrap sizes and designs you are interested in offering.

Sizes:

Adult
Child
Baby/Infant
All sizes

Expected Order Type:

Individual orders as needed
Stocking inventory
Special for families
Combination of inventory and special orders

your use, Country

5. Tax-Exempt Resale Information

Provider Partner purchases may qualify as tax-exempt resale purchases only when the products are purchased for resale and when the proper resale or exemption documentation has been provided and approved.

Sales Tax/Resale Permit Number:

State of Issue

Federal EIN, if applicable

Are your purchases being made for resale?

Will any products be used for display, samples, internal business use, donations, or non-resale purposes?

Yes
No
Not sure

If yes, please explain.

Required Documentation Upload

Drag & Drop Files, Choose Files to Upload

Please upload a current resale certificate, sales tax exemption certificate, or other applicable tax-exempt documentation. Minnesota Applicants: Please refer to "Sales Tax Fact Sheet 165", covering Funeral Homes, Mortuaries, Crematories, and Cemeteries. Out-of-State Applicants: Please provide a current resale certificate, exemption certificate, or multi-state certificate acceptable for your state and the state to which products will be shipped.

Applicant Acknowledgement:

I certify that purchases made through this Provider Partner account are for resale unless otherwise disclosed.
I understand that Bluff Country Quilting LLC may charge sales tax if my resale or exemption documentation is missing, incomplete, expired, invalid, or not applicable.
I understand that I am responsible for the accuracy of my resale or tax-exempt documentation.
I agree to notify Bluff Country Quilting LLC if my resale status, permit number, business status, or tax-exempt eligibility changes.

6. Trade-Partner Sales Practices

How will you present Bluff Country Quilting burial wraps to customers or families?

As a green burial option
As a handcrafted burial wrap
As an alternative to traditional burial products
As part of funeral planning services
As part of natural burial education
Other: _______________________________

Will you use Bluff Country Quilting LLC product images, descriptions, or marketing materials?

Yes
No
Requesting Permission

Will you advertise Bluff Country Quilting LLC products online?

Do you agree not to make unapproved claims about biodegradability, certification, religious suitability, legal burial requirements, or environmental impact?

7. Account Terms Requested

Requested Account Type

Preferred Payment Method:

Credit card
ACH / bank transfer
Check

Do you request payment terms?

No
Yes — please explain:

Explanation:

Purchase Order Required?

8. Provider Partner Agreement Acknowledgment

By submitting this application, the applicant agrees that:

Approval as a Provider Partner is at the sole discretion of Bluff Country Quilting LLC.
Wholesale or reseller pricing is confidential and may not be publicly posted without written authorization.
Tax-exempt purchasing privileges are not active until proper documentation has been received and approved.
Products purchased tax-exempt for resale may not be diverted for personal, internal, sample, donation, or non-resale use without proper tax treatment.
Bluff Country Quilting LLC product images, descriptions, logos, and marketing materials may not be used without permission.
The applicant will represent Bluff Country Quilting LLC products accurately, respectfully, and in keeping with the dignity of end-of-life care.
Bluff Country Quilting LLC may request updated resale or exemption documentation at any time.
Bluff Country Quilting LLC may suspend or terminate Provider Partner privileges for inaccurate information, misuse of tax-exempt status, unauthorized marketing claims, nonpayment, or conduct inconsistent with the company’s standards.

9. Signature

I certify that the information provided in this application is true and complete to the best of my knowledge. I am authorized to submit this application on behalf of the business named above.

Authorized Representative Name:

Title:

Signature

Clear Signature