Distributors and Wholesalers Click Here

1. In order for a wholesale-reseller to qualify to sell our product, you will need to fill out the form below and return it to us.
2. As soon as we receive this form below filled out in its entirety please fax, scan, or email it back to us. We will review it for approval.
3. Assuming the wholesale-reseller is approved, we will then have you create a unique user name and password in order to log in to the Boost My Fuel online portal for wholesalers.

Distributor / Wholesale Terms & Conditions Application

Business Name:_____________________________________________________________
Owner/Manager:____________________________________________________________
E-mail Address:_____________________________________________________________
Website address:____________________________________________________________
How did you find out about BOOST MY FUEL, products:______________________________
Number of years in business:___________________________________________________
Business Address:____________________________________________________________
City, State, Zip:______________________________________________________________
Phone:____________________________ E-Mail:__________________________________

(1.) Fill out the information on this page, along with the Resale Tax Exempt Form #13.

Please either Fax
to: (877) 261-8627, or scan and e-mail to Kelly@boostmyfuel.com
If you have any questions, call: 1-402-489-1000

(2.) Soon as we receive the completed Terms and Condition Application, we will begin to process for
potential approval.
BOOST MY FUEL, Refund Policy
Returns, refunds, and instruction policy:
Your purchased item must be in its original unused condition to be returned, unless there is a
manufacturer defect. Product must be returned within 30 days of purchase. Soon as package is
received, it will be evaluated/ inspected, for a potential refund.
(a.) Mail/Ship returned item to: BOOST MY FUEL, 1424 Imperial Dr.,Lincoln, NE. 68506
(b.) Include in your package; (1.) A letter, stating the reason of return, with purchaser’s
signature. (2.) Copy of original receipt. (3.) Purchaser’s mailing address.

(3.) Returned refunded item to be shipped to address (a. above) at buyers expense.
Return Exclusions:
1.) Items will not be accepted for refund credit, if they have been opened.
2.) Merchandise that has been opened or altered, will not be accepted for return or exchange
credit.
3.) Shipping and handling cost paid on the original order, and returned goods is not refundable.

Owner/Manager Signature:_____________________________________ Date:_____________

We appreciate your business, and look forward to working with you.

Thank You,

Boost My Fuel