173 Oak St.
Marion, OH 43302
740-382-8100 phone

Dealer Application

Name of Business: ____________________________________________

Contact Person: ____________________________________________

Address: ____________________________________________

City, State Zip: ____________________________________________

Business Phone: ____________________________________________
(must be listed in business name)
Fax: ____________________________________________

E-mail ____________________________________________

Web site (if available) _____________________________________________________

Federal ID #: ____________________________________________

State Resale License: _____________________________________________
General Description of Business: _________________________________
ATV/ UTV Related Trade References:
1. ___________________________________________________________
2. __________________________________________________________
3. __________________________________________________________
How long have you been in business? ______________________________
I declare that the statements above are true and I authorize Houser Products, LLC to check my credit references.

Signature of Owner: _____________________Date: __________________
Note: Final approval of this application cannot be given without a photocopy of:
Your company check
State Business license or equivalent
Business name and telephone number in the directory, (white or yellow pages). Or a copy of a phone bill and picture of the store front for a new company.

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