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DEALER Application

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

Company name:

Address:

City:
 

State:

ZIP Code:

Phone:

Fax:

E-mail:

Type of account:

Company name:

Address:

City:

State:

ZIP Code:

 

Phone:

Fax:

E-mail:
 

Type of account:

Company name:

Address:

City:
 

State:

ZIP Code:

Phone:

Fax:

E-mail:
 

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:

Title:

Date:

Please fill the application out completely and fax or mail it back.
Fax: 989-883-3135
3053 Myers Road
Sebewaing, MI 48759

 

A copy of one of the following is also required:

State Sales Tax License
Business License
Print advertisement from a magazine or newspaper