WARNING: Vaping products contain nicotine, a highly addictive chemical. - Health Canada

Owner Information

Business Owner Name
Business Info

The name registered with the CRA

The name used by the company to do business.

The 9-digit number the CRA assigns to businesses and other organizations for tax-related purposes.

Types of Business*

Please Specify Other Business*

Shipping Address
Billing Address
Business License

Please upload a scan or copy of your government registered Business and/or Tax License. Pdf or image file, maximum size 10MB.

Please upload a scan or copy of your government registered Speciality Vape License. Pdf or image file, maximum size 10MB.

Other Information
Are You Tax Exempt*

Please upload a scan or copy of your government registered native status card

Please upload a scan or copy of your government registered native status card

Authorization
Signature of Business Owner / Authorized Representative