DEALER ACCOUNT APPLICATION & AGREEMENT ← BackThank you for your response. ✨ COMPANY (required) Warning DBA (DOING BUSINESS AS) Warning BILLING STREET(required) Warning BILLING CITY(required) Warning BILLING STATE(required) Warning BILLING ZIP (required) Warning SHIPPING STREET ADDRESS(required) Warning SHIPPING CITY, STATE, ZIP CODE(required) Warning FEIN NUMBER (FEDERAL EMPLOYER IDENTIFICATION NUMBER)(required) Warning PURCHASING CONTACT EMAIL(required) Warning PURCHASING TELEPHONE(required) Warning EMPLOYEE COUNT(required) Select one option 1~5 6~10 11~20 20~50 100+ Warning YEAR ESTABLISHED (required) Warning ANNUAL REVENUE(required) Select one option LESS $500K $501K~1 MILLION $1.1MILLION~$2 MILLION $2.1MILLION + Warning BUSINESS DYNAMICS(required) STORE FRONT INSTALLER WEBSTORE MARKET PLACE PLATE FORM Warning PRIMARY MARKET FOCUS(required) TRUCK AND OFFROAD DIESEL JEEP MUSCLE EUROPEAN POWERSPORTS ELECTIC VEHICLES GENERAL REPAIR Warning BUSINESS STRUCTURE(required) SOLE PROPRIETORSHIP PARTNERSHIP LLC CORPORATION Warning NAME OF OWNER, FIRST AND LAST NAME(required) Warning OWNERSHIP PERCENTAGE(required) Warning CURRENT SUPPLIER – COMPANY 1(required) Warning CURRENT SUPPLIER – COMPANY 2(required) Warning TERMS AND CONDITION Warning FIRST NAME(required) Warning LAST NAME(required) Warning TITLE(required) Warning Date (YYYY-MM-DD)(required) Warning Other Details Warning Warning. SendSubmitting form Δ