Garber Credit Application & ACH — Webform

Fill, sign, then click Export to PDF and email the saved file to info@garberwine.com.

Ship To Info

Business Name

DBA (Trade Name)

Address

City, State, ZIP

Phone

Proprietorship — Partnership — Corporation (Circle One)

Proprietorship Partnership Corporation

State of Incorporation

Alcoholic Beverage License #

Business Resale Permit #

Federal Tax ID

Address

Owner Contact Info

Name

Phone

Address

City, State, ZIP

CREDIT TERMS AND CONDITIONS

For the purpose of obtaining merchandise from Garber & Co., … (full terms text here) …

Signature (sign below)

Date

RESALE CERTIFICATE

I HEREBY CERTIFY: … DESCRIPTION OF PROPERTY TO BE PURCHASED: WINE.

Printed Name of Purchaser or Authorized Agent

Title of Signing Authorized Agent

Signature (sign below)

Date

As of January 2026 the state of California requires all alcohol sales receive payment online.

Please select which e-payment method you will be using. Payment terms are 30 days. After 60 days interest will be charged.

Payment Methods

Melio Bill.com Direct ACH payment to Garber (will email bank info) Fintech Ottimate Direct ACH withdrawal by Garber (please fill out attached ACH form) Other

If Other, specify

Invoice Preferences

Yes No

If Yes, Email

AP Contact Info

Name

Title

Phone

Buyer Contact Info

Name

Title

Phone

Final Authorization

Authorized Signature (sign below)

Date

ACH PAYMENT AUTHORIZATION FORM (must be filled out completely)

PLEASE COMPLETE THIS FORM AND FAX TO 310.455.0999 OR EMAIL TO INFO@GARBERWINE.COM

Billing Information

Business Name

DBA (Trade Name)

Address

City, State, ZIP

Phone

Bank Information

Account Name

Bank Name

Account Number

Routing Number

Account Type: Checking Savings

Contact Information

Contact Name

Contact Email

Contact Phone

Authorization

By signing below, I authorize Garber & Co. to initiate ACH transactions from the account listed above.

Account Holder’s Signature

Date

After completing, click Export to PDF and email to info@garberwine.com.