Natrol LLC and Jarrow Formulas, Inc. New Account Application for the United States

Natrol LLC and Jarrow Formulas, Inc.

New Account Application for the United States

Thank you for your interest in joining our valued family of Authorized Sellers. If you would like to apply for an account with Natrol LLC and/or Jarrow Formulas, Inc., please complete and submit this New Account Application.

Please be prepared to attach the following required documents to this application:

A copy of your State Sellers Permit;
A copy of your Resale Certificate or Sales Tax Exemption Certificate;
A copy of your City/Town/County Business License;
A copy of your valid Practitioner or Physician License if you are a practitioner or physician.

Do not submit any sensitive personal information such as social security numbers or credit card numbers.

The information submitted to us in this New Account Application form is governed by our privacy policy. Please see the Jarrow Formulas, Inc. Privacy Policy and Natrol LLC Privacy Policy for more information.

If you have any questions, please contact our New Accounts team via email at newaccount@vytalogy.com or via our web forms on the Natrol website or the Jarrow Formulas website.

To receive a copy of your completed application, be sure to check "Send me a copy of my responses" at the bottom of this application form.

Please note that in the United States, Vytalogy Wellness has a unilateral Minimum Advertised Price Policy for the Natrol and Jarrow Formulas brands. The purpose of this notice is to inform you of the existence of this policy and does not constitute an agreement between you and Vytalogy Wellness or any of its brands, affiliates, or entities regarding the terms of the policy.

Applicant's Information

Applicant's Legal Name*

DBA / Trade Name*

Physical Address*

Physical Address 2

City*

State*

Select

Zip Code*

Is the Applicant's billing address different than the above physical address?*

Yes, billing address is different from physical address

No, billing address is same as physical address

Applicant Billing Address*

Billing Address 2

Billing City*

Billing State*

Select

Billing Zip Code*

Applicant's Shipping Address*

Same as physical address

Same as billing address

Shipping address is different

Applicant Shipping Address*

Shipping Address 2

Shipping City*

Shipping State*

Select

Shipping Zip Code*

Primary Contact Name*

Primary Contact's Title*

Primary Contact's Email*

Telephone*

Phone

Fax

Phone

Entity Type*

Corporation

LLC

Partnership

Sole Proprietorship

State of Incorporation*

Select

Year Incorporated*

DUNS*

Example: 15-048-3782

EIN*

Example: 12-3456789

Do not provide a SSN. If you do not have an EIN, enter "None".

Resale Certificate Number*

Resale Certificate Issuing State*

Select

Are you a physician or practitioner?*

If yes, please attach a copy of your valid Practitioner or Physician license.

Yes

Do you have an existing account with Natrol and/or Jarrow Formulas?*

Yes - Natrol

Yes - Jarrow Formulas

Yes - Natrol and Jarrow Formulas

Natrol Account Number(s) and/or Account Name(s)*

Jarrow Formulas Account Number(s) and/or Account Name(s)*

How do you intend to sell the Natrol and/or Jarrow Formulas products?*

Brick-and-mortar

Online

Brick-and-mortar and Online

Brick-and-Mortar Sales Information

How long have you been engaged in brick-and-mortar sales?*

How many brick-and-mortar storefronts do you have in the United States?*

Provide the full address of each brick-and-mortar storefront in which you intend to sell the Natrol and/or Jarrow Formulas products in the U.S.*

If more space is needed, continue list in Additional Information section.

What types of products do you sell in your brick-and-mortar storefronts that you intend to sell the Natrol and/or Jarrow Formulas products in?*

Check all that apply.

You selected "Other" in the question above. Please list the types of products you sell in your brick-and-mortar storefronts.*

Do you intend to store your inventory of Natrol and/or Jarrow Formulas products at a location other than the brick-and-mortar storefront(s) addresses identified above?*

No, I intend to store my inventory at the brick and mortar storefront address(es) identified above

Yes, I intend to store my inventory elsewhere

Please provide the address for all locations where such inventory will be stored.*

Online Sales Information

How long have you been engaged in ecommerce sales?*

On what websites / online marketplaces do you engage in ecommerce sales?*

For online marketplaces, please include the Storefront Name and/or Merchant ID.

Website Example: www.ABCStoreName.com

Online Marketplace Example: Amazon.com / “ABC Store” / Merchant ID

What types of products do you currently sell on your existing websites / online marketplaces?*

Check all that apply.

You selected "Other" in the question above. Please list the types of products you sell on your existing websites / online marketplaces.*

Requested Websites*

Please identify all websites or mobile applications through which you wish to sell Natrol and/or Jarrow Formulas products.

Exact spelling required.
For online marketplaces, include the Storefront Name and the Merchant ID.

Website Example: www.ABCStoreName.com

Online Marketplace Example: Amazon.com / “ABC Store” / Merchant ID

General Information

How did you hear about Natrol and/or Jarrow Formulas?

Which brand(s) are you interested in selling?*

Natrol

Jarrow Formulas

Natrol and Jarrow Formulas

Which Natrol and/or Jarrow Formulas products are you interested in selling?

To whom do you intend to sell the Natrol and/or Jarrow Formulas products?*

End user consumers

Persons and/or entities who intend to resell the Natrol and/or Jarrow Formulas products to end users

Do you already sell Natrol and/or Jarrow Products?*

Yes

Where are you currently selling Natrol and/or Jarrow Formulas products?*

If brick and mortar store(s), please include the address.
If online, please list the websites (and storefront names if selling on an online marketplace).

Please identify all sources of the Natrol and/or Jarrow Formulas products you are selling or intend to sell.*

Check all that apply.

Purchase directly from Natrol and/or Jarrow Formulas

Purchase from Distributor(s)

Other

Please list the distributors.*

You selected "Other" in the question above. Please describe.*

Do you intend to use any third-party fulfillment service or third-party logistics provider to store inventory or fulfill orders of Natrol and/or Jarrow Formulas products (including any drop-shipping arrangement)?*

Yes, I intend to use a third-party fulfillment service or logistics provider to store inventory or fulfill orders of Natrol and/or Jarrow Formulas products

No, I do not intend to use a third-party fulfillment service or logistics provider to store inventory or fulfill orders of Natrol and/or Jarrow Formulas products

Please identify the name(s) of the third-party fulfillment service and/or third-party logistics provider and describe the services provided.*

Would you like to be added to our store locator on our website?*

Yes

Requested Payment Terms*

If the Applicant is approved to sell Natrol and/or Jarrow Formulas products, payment terms will be prepay unless and until approved by Natrol and/or Jarrow Formulas for credit terms.

If the Applicant would like to apply for credit terms, please request a credit application from our team.

Prepay (credit card, ACH or wire)

Credit (please complete our Credit Application)

Has the Applicant ever been a debtor in any bankruptcy, receivership, or other insolvency proceeding?*

Yes

If yes to the above question, please explain the matter in detail below.*

Please attach a document if more space is needed.

Has any company in which any of the Applicant’s principals hold an ownership interest ever been a debtor in any bankruptcy, receivership, or other insolvency proceeding?*

Yes

If yes to the above question, please explain the matter in detail below.*

Please attach a document if more space is needed.

Are there any pending lawsuits involving the Applicant?*

Yes

If yes to the above question, please explain the matter in detail below.*

Please attach a document if more space is needed.

Additional Information

Include additional relevant information here.

Attachments

Attach required documents and other relevant documents*

Required documents:

A copy of your State Sellers Permit or Resale Certificate

A copy of your City/Town/County Business License

A completed, signed W-9

A copy of your valid Practitioner or Physician license if you are a practitioner or physician

At least 5 photographs of your brick-and-mortar storefronts if applying to sell Natrol and/or Jarrow Formulas products in a brick-and-mortar store

Do not submit any sensitive personal information such as social security numbers or credit card numbers.

Drag and drop files here or

Attachments Checklist*

I attached my State Sellers Permit or Resale Certificate

I attached my City/Town/County Business License

I attached my complete, signed W-9

I attached my valid Practitioner or Physician license (or N/A)

I attached 5 or more photos of my store (or N/A)

Applicant Certification

By checking the boxes below and typing your name in the "Signature" section below, you agree to the terms set forth next to each of the following terms.

If you do not understand or accept or agree to the terms set forth below, then (1) do not check the boxes below, (2) do not submit this application, and (3) exit this site.

I certify that the information provided in this Application on behalf of the Applicant is true and accurate.*

I understand that authorization to sell Natrol and/or Jarrow Formulas products (brick-and-mortar and/or online) is ONLY granted if an authorized representative of Natrol LLC and/or Jarrow Formulas, Inc. affirmatively provides the Applicant with express written approval.*

If the Applicant is approved to sell Natrol and/or Jarrow Formulas products, the Applicant agrees that it will abide by the terms in the currently effective (a) Natrol LLC and Jarrow Formulas, Inc. Authorized Distributor Policy for the United States, (b) Natrol LLC and Jarrow Formulas, Inc. Authorized Retailer Policy for the United States, or (c) Natrol LLC and Jarrow Formulas, Inc. Authorized Reseller Policy for the United States, as applicable (each, the “Policy”) or (d) the Authorized Retailer Agreement if such agreement is duly executed.*

Email address where Natrol / Jarrow Formulas is to send the applicable Policy or Agreement*

Note, this person should be authorized to sign the Agreement on behalf of the Applicant

If the Applicant is approved to sell Natrol and/or Jarrow Formulas products, the Applicant agrees that it is subject to and will abide by the Terms and Conditions of Sale in the currently effective Natrol LLC and/or Jarrow Formulas, Inc. Terms and Conditions of Sale available on each of the Natrol and Jarrow Formulas websites (https://www.natrol.com/pages/reseller-terms-of-sale and https://jarrow.com/pages/reseller-terms-of-sale), respectively (the “T&Cs”). Natrol LLC and Jarrow Formulas, Inc. expressly reject any terms or conditions that are additional to or different from the T&Cs. Neither Natrol LLC’s nor Jarrow Formulas, Inc.’s delivery of products, nor any other action, conduct, or performance shall constitute acceptance of terms or conditions different from the T&Cs. Applicant shall be deemed to have accepted the T&Cs by submitting this New Account Application.*

T&Cs Hyperlinks

Natrol LLC Terms and Conditions of Sale

Jarrow Formulas, Inc. Terms and Conditions of Sale

If the Applicant is approved to sell Natrol and/or Jarrow Formulas products, the Applicant understands that its payment terms will be prepay unless and until it is approved by Natrol and/or Jarrow Formulas for credit terms. If the Applicant would like to apply for credit terms, please request a credit application from our team.*

Applicant's Signature

By typing your name in the "Signature" field below and clicking the "Submit" button at the bottom of this form, you are signing this Natrol and Jarrow Formulas, Inc. New Account Application electronically. You understand and agree that your electronic signature has the same legal force and effect as your manual signature on this application.

You also represent that you are authorized to sign this application form on behalf of the Applicant.

By checking this box and typing my name below, I am electronically signing this application.*

Signature*

Example:

/John Doe/

Legal Name*

Title*

Signature Date*

To receive a copy of your application, be sure to check "Send me a copy of my responses" below.

Send me a copy of my responses

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