EMAIL ADDRESS OF PERSON SUMBITTING FORM. REQUIRED - IF PROVIDED BY A STORE, PLEASE USE YOUR STORE EMAIL ADDRESS
LEGAL CLASSIFICATION OF ITEM.
SELECT THE MOST APPROPRIATE OPTION
SELECT THE MOST APPROPRIATE OPTION
SELECT THE MOST APPROPRIATE OPTION
SELECT THE MOST APPROPRIATE OPTION
SELECT THE MOST APPROPRIATE OPTION
SELECT THE MOST APPROPRIATE OPTION
SELECT THE MOST APPROPRIATE OPTION
SELECT THE MOST APPROPRIATE OPTION. IF THE PRODUCT IS MADE IN INDIANA, PLEASE SELECT INDIANA HERE.
SELECT THE MOST APPROPRIATE 'SELLING SIZE' OPTION. IF SOLD BY 'PACK' PLEASE SELECT APPROPRIATE PACK SIZE. IF SOLD BY SINGLE SELECT AN ML/OZ SIZE.

Product Info

PRODUCT NAME ON ACTUAL SELLING UNIT - I.E. BUD LIGHT LIME 6 PACK, ABSOLUT HANGOUT VARIETY 12 PACK, MARLBORO SPECIAL SELECT BOX, ETC. THE PRODUCT'S SHELF LABEL NAME WILL BE DETERMINED BY THIS. PLEASE BE SPECIFIC.
FOR EXAMPLE IS THE SELLING UNIT A GLASS BOTTLE, PLASTIC BOTTLE, CAN, TETRA, BOX, ETC.
HOW MANY SELLING UNITS COME IN AN UNBROKEN CASE FROM THE SUPPLIER? I.E. FOR MOST 6 PACK BOTTLED BEER THIS IS 4. FOR MOST 4 PACK CANNED BEER THIS IS 6. MOST 750 SPIRITS IS 12. ETC.
COMPANY NAME ON INVOICE PROVIDED BY THE SUPPLIER. I.E. SOUTHERN, NATIONAL, BEST BEER, ETC.
THIS FIELD IS TYPICALLY FOR USE BY THE SUPPLIER. WHICH "BOOK" IS THIS FROM? I.E. D&E, SIGNATURE, FOX, ETC.
SUPPLIER SPECIFIC NUMBER, FOUND ON INVOICE PROVIDED BY SUPPLIER.
LISTED COST OF CASE ON SUPPLIER INVOICE.
THIS IS THE BARCODE NUMBER SCANNED AT THE REGISTER. TYPICALLY A 12 DIGIT NUMBER FOUND ON THE SELLING UNIT ITSELF. PLEASE DO NOT USE DASHES, SPACES, OR ANY OTHER NON NUMERICAL CHARACTERS. (CORRECT: 012222688692 INCORRECT: 0-12222-68869-2)
TASTE PROFILE INFORMATION FOR USE WITH SIGNAGE. NOT REQUIRED.
Drop files here or
Accepted file types: jpg, jpeg, png, webp, Max. file size: 4 MB.
    IF POSSIBLE, PLEASE PROVIDE A PICTURE OF BOTH THE FRONT AND BACK OF THE PRODUCT. NOT REQUIRED.