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Company Name *

Resale Certificate Number (US ONLY)

Foreign Company ID Number

Address *

Address Line 2

State

City *

ZIP Code

Country *

Website

First Name *

Last Name *

Job - Position *

Your phone number *

Please describe your services

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I hereby authorize SoundShine Miami Distributors to utilize the provided information in order to create a new account record *

Your company industry *

Forwarder Name (Export Only)

Forwarder Address

Forwarder City, State, ZIP Code

Username *

User Password *

Confirm Password *

User Email *

Confirm Email *