Dealer Application

Company Information

Legal Business Name

DBA

Federal Tax ID No. (SSN if DBA)

Company Structure

Principle Owner's First Name

Principle Owner's Last Name

Company Phone

Company Email

State Sales Tax Number

Website Address

How did you hear about us?

Company Type:

Ecommerce

Brick and Mortar

Install Shop

Repair Shop

Authorized Buyer

Name

Phone

Accounts Payable Contact

Same as authorized buyer

Name

Phone

Billing Address

Street

City

Country

State/Province

Zip

Shipping Address

Same as billing address

Street

City

Country

State/Province

Zip

Documents

re-sell certificate

business license

picture of retail showroom

picture of shop

Terms and Conditions

I have read and agree to the Terms and Conditions.