173 Oak St.

Marion, OH 43302

740-382-8100 phone

740 382-8199 fax

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.