DEALER APPLICATION Complete and send to marketing@sfmparts.com COMPAN Y NAME: __________________________________________________ __________________________ BUSINESS TYPE: _______________________________________________________________________ FEIN: _____________ ___________________________________________________________________ B USI NESS LIC ENSE NUMBER: ____________________________________________________________ _ IS SUIN G STATE: ________________________________________________________________________ P lease include a copy of your business license PRIMARY CONTACT : ________________________________________________ __________________________ PRIMARY PHONE: ______________________________________________________________________ ALTERNATE P HONE: ____________________________________________________________________ EMAIL ADDRESS : _______________________________________________________________________ CO MPANY WEBSITE: ________________ ____________________________________________________ BILLING INFORMATION (AS IT APPEARS ON YOUR CREDIT CARD STATEMENT) STREET ADDRESS: _______________________________________________________________________ CITY: __________________________________________________________________________________ STATE: _______________________________________________ _________________________________ ZIP CODE: ______________________________________________________________________________ SHIPPING INFORMATION STREET ADDRESS: _______________________________________________________________________ CIT Y: _____________________________________________________________________ _____________ STATE: ________________________________________________________________________________ ZIP CODE: ______________________________________________________________________________ INDUSTRY REFERENCES REFERENCE 1: ___________________________________________________________________________ ACCOUNT NUMBER: ______________________________________________________________________ REF ERE NCE 2: ____________________________________________________________________________ ACCOUNT NUMB ER: ____________________________ __________________________________________ EXPECTED MONTH LY PARTS VOLUME: ______________________________________________________________ ARE YOU AN EXISITING SFM PARTS CUSTOMER? ______________________________ ________________________ WHERE DID YOU HEAR ABOUT US ? _________________________________________________________________ _