![]() 173 Oak St. Marion, OH 43302 740-382-8100 phone 877-6-GO-FAST 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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