It is your responsibility to make sure that the information submitted on this form is accurate.
*Please note that if your business is located outside the state of Louisiana to please place N/A in all banking information and tax exempt sections. You will need to provide a credit card and matching ID for billing prior to shipping. Credit card and ID can be attached below.
Name of Business*
Name of Corporation and/or Legal Entity*
Shipping Address*
Billing Address*
if same as Shipping Address
Phone Number*
Email*
Type of Business*
Restaurant
Grocery/Retail Market
Other
Legal Entity*
Corporation
Partnership
Proprietorship
LLC
Federal Tax ID (EIN)*
Does the business have a Sales Tax Exemption Certificate?* (for LA businesses only) *Must be provided to receive wholesale pricing. Retail pricing will be quoted if not provided or if not exempt.
If yes, MUST PROVIDE A COPY to LA Best Seafood to have on file. Yes
If yes, MUST PROVIDE A COPY to LA Best Seafood to have on file. No
Out of state customer. Does not apply. N/A
Louisiana Account Number (found on LDR Resale Certificate)* (For LA businesses only)
Attach LA Sales Tax Exemption Certificate *Must be provided to receive wholesale pricing. See above.
Upload document below:
Parish/County in which the business is located* (For LA businesses only)
Parish Account Number (found on Parish Resale Certificate)* (For LA businesses only)
Attach Parish Sales Tax Exemption Certificate *Must be provided if LA Sales Tax Exemption Certificate not provided. See above. (For LA businesses only)
Accounts Payable Contact*
Bank Information* (for businesses in the state of LA)
Credit Card Info and Photo ID Upload (for businesses outside of LA)
Card Type: (information must be provided for businesses outside of LA)
Please select card type
Upload Photo ID matching Credit Card below:
Trade References (Major supplies only - Alcohol/Liquor references not applicable)*
Reference 1*
Reference 2*
Reference 3*
Hours of Operation*
Preferred Receiving Hours*
Southwest Air Cargo Destination (for businesses outside of LA)
Please select Southwest Air Cargo Destination
*If you do not see your airport of choice, SWAC does not currently have a facility.
*By law we are not able to ship live crawfish into the following states: Hawaii, Illinois, Michigan, Minnesota, Pennsylvania, Washington and Wisconsin.
*Oregon requires a permit to ship live crawfish.
*By law we are not able to ship live crabs into the following states: Oregon.
Preferred Delivery Day*
Please select your preferred delivery day. However, your selection does not guarantee we deliver to your area on the selected day. We do have a $250 minimum delivery. Orders below $250 will result in a $10 Fuel Surcharge.Monday
Please select your preferred delivery day. However, your selection does not guarantee we deliver to your area on the selected day. We do have a $250 minimum delivery. Orders below $250 will result in a $10 Fuel Surcharge.Tuesday
Please select your preferred delivery day. However, your selection does not guarantee we deliver to your area on the selected day. We do have a $250 minimum delivery. Orders below $250 will result in a $10 Fuel Surcharge.Wednesday
Please select your preferred delivery day. However, your selection does not guarantee we deliver to your area on the selected day. We do have a $250 minimum delivery. Orders below $250 will result in a $10 Fuel Surcharge.Thursday
Please select your preferred delivery day. However, your selection does not guarantee we deliver to your area on the selected day. We do have a $250 minimum delivery. Orders below $250 will result in a $10 Fuel Surcharge.Friday
Please select your preferred delivery day. However, your selection does not guarantee we deliver to your area on the selected day. We do have a $250 minimum delivery. Orders below $250 will result in a $10 Fuel Surcharge.Saturday
Customers who are out of state and not in an area available to ship via Southwest should choose the option to pick up their orders. Order minimums are waived for warehouse pick up.Pick Up
