|
DEALER APPLICATION |
| Name:
_______________________________ |
Resale Tax ID: ____________________________ |
| Address:
______________________________ |
(If you reside in a state
or province that does not issue Tax ID's, please send a copy
of your business license) |
| Address 2:
____________________________ |
| City:
_________________________________ |
|
| State: ____________ Zip Code:
___________ |
|
| Phone: _______________________________ |
Your Building is: |
| Fax: _________________________________ |
Owned
Rented
|
| Email:
________________________________ |
Residential
Commercial
|
| |
|
| Bank Name: ___________________________ |
Current Open Wholesale Accounts: |
| Address:
______________________________ |
|
| Address 2:
____________________________ |
Name:
_______________________________ |
| City:
_________________________________ |
Address:
______________________________ |
| State: ____________ Zip Code:
___________ |
Address 2:
____________________________ |
| Phone: _______________________________ |
City:
_________________________________ |
| Bank Contact:
_________________________ |
State: ____________ Zip Code:
___________ |
| |
Phone: _______________________________ |
|
|
| I verify that all information
on this application is correct and grant Cinch Hook and its
owners permission to contact and verify references listed on
this form. |
Name:
_______________________________ |
| |
Address:
______________________________ |
| ______________________________________ |
Address 2:
____________________________ |
|
(Printed Name) |
City:
_________________________________ |
| |
State: ____________ Zip Code:
___________ |
| ______________________________________ |
Phone: _______________________________ |
