Business Contact Information
Contact Name:
Company name:
Phone:
Fax:
E-mail:
Address:
City:
State:
ZIP Code:
Date business commenced:
Sole proprietorship:
Partnership:
Corporation:
Other:
How long at current address?
Type of Dealership (Circle all that apply): Online Mail-Order Franchised Accessories Service
Business/trade references
Type of account:
Agreement
1. All invoices are to be paid before the items are shipped.
2. Claims arising from invoices must be made within seven working days.
3. All orders must be paid with a credit card. PayPal is also accepted.
Signatures
Title:
Date:
Please fill the application out completely and fax or mail it back. Fax: 989-883-3135 3053 Myers Road Sebewaing, MI 48759