Pact Act Form

PLEASE SUBMIT YOUR BUSINESS DOCUMENTS

Business VerificationTo activate your account, please fill out this form, including your email address, shipping address and business documents.

If you have multiple shipping addresses, you must submit this form for each shipping address.

Please submit your business documents 2

Business Name *

Email *

FEIN *

Business Contact Name *

Customer Email Address *

What is the email address associated with your Kico account?

Phone *

Shipping Address *

Shipping Address

Street Address

Street Address

Address Line2

Address Line2

City

City

State / Province / Region Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

State / Province / Region

Zip Code/Postal

Zip Code/Postal

REQUIRED FOR MOST JURISDICTIONS – Please upload a copy of your Sales Tax License (sometimes called Reseller’s Certificate, or Sales & Use Permit, etc).

Sales Tax License / Reseller’s Certificate

Choose File

Maximum upload size: 5MB

Expiration Date of Sales Tax License/Reseler’s Certificate

REQUIRED FOR MOST JURISDICTIONS – Please upload a copy of your OTP/Tobacco License (sometimes called Vapor Products Certification etc).

OTP/Tobacco License

Choose File

Maximum upload size: 5MB

Expiration Date of OTP/Tobacco License

Please upload the business license associated with the shipping address above. Required for most jurisdictions.

Business License

Choose File

Maximum upload size: 5MB

Please upload the Certificate of Good Standing associated with the shipping address above. Required for most jurisdictions.

Certificate of Good Standing

Choose File

Maximum upload size: 5MB

Submit