All Natural Insect Repellents & Pest Control

HOMS Product Dealer Application

HOMS is pleased to offer this Wholesale Account to qualified US Businesses only.  HOMS is the manufacturer of BiteBlocker® Natural Insect Repellent which is regarded by the USDA as the most effective natural insect repellent.  This product is exempt from regulation under FIFRA, 40CFR, Sec.152.25 (g) (1), (2) and (3), minimum risk pesticides.  HOMS also wholesales a complete line of organic insecticides, Pet and animal products and other pest control products. Please fax this application with a copy of your tax exempt license if applicable to (888) 270-5721.  For written correspondence, you may send mail to PO Box 1887, Pittsboro, NC 27312.  Send us an E-mail.

Business Name (Dealer):
Business Address:
Business City:
Business State:
Business Zip Code:

*If business is located in North Carolina - fax copy of FEIN or Business License with State Tax ID to 919-553-6616
Business Country:
Shipping Address (via USPS):

*if different from business address
Shipping Address (via UPS/FedEx):

*if different from business address.
Years in Business:
Business Established in (State):
Type of Business (Description)
FEIN of Tax Exempt Business:

*Required for all Businesses
Contact Name:
Phone:
Fax:
E-mail:
Include Business in Store Finder:
Comments:

Copyright © 2002 - 2010 HOMS, LLC. All rights reserved. HOMS, BiteBlocker®, Eco-Shield®, Bio Block®, BioUD®, Eco Organic Blender™, and BiteBlocker for Kids™ are registered trademarks of HOMS, LLC. Any unauthorized use of these trademarks without the written consent of HOMS, LLC is strictly prohibited.