SFMParts Dealer Application.pdf - Andrew Kent

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DEALER APPLICATION Complete and send to [email protected] COMPANY NAME: ____________________________________________________________________________ BUSINESS TYPE: _______________________________________________________________________ FEIN: ________________________________________________________________________________ BUSINESS LICENSE NUMBER: _____________________________________________________________ ISSUING STATE: ________________________________________________________________________ Please include a copy of your business license PRIMARY CONTACT: __________________________________________________________________________ PRIMARY PHONE: ______________________________________________________________________ ALTERNATE PHONE: ____________________________________________________________________ EMAIL ADDRESS: _______________________________________________________________________ COMPANY WEBSITE: ____________________________________________________________________ BILLING INFORMATION (AS IT APPEARS ON YOUR CREDIT CARD STATEMENT) STREET ADDRESS: _______________________________________________________________________ CITY: __________________________________________________________________________________ STATE: ________________________________________________________________________________ ZIP CODE: ______________________________________________________________________________ SHIPPING INFORMATION STREET ADDRESS: _______________________________________________________________________ CITY: __________________________________________________________________________________ STATE: ________________________________________________________________________________ ZIP CODE: ______________________________________________________________________________ INDUSTRY REFERENCES REFERENCE 1: ___________________________________________________________________________ ACCOUNT NUMBER: ______________________________________________________________________ REFERENCE 2: ____________________________________________________________________________ ACCOUNT NUMBER: ______________________________________________________________________ EXPECTED MONTHLY PARTS VOLUME: ______________________________________________________________ ARE YOU AN EXISITING SFM PARTS CUSTOMER? ______________________________________________________ WHERE DID YOU HEAR ABOUT US? __________________________________________________________________