15-110
Ironside Cres, Scarborough, On M1X 1M2 E-mail- [email protected]
DEALER APPLICATION
COMPANY NAME
___________________________________________________________
ADDRESS ______________________________________ PH1
( ) ________________
CITY
________________________ STATE _______________ ZIP _________________
PH2 (
)____________________ FAX (
)
_______________________________
THE LENGTH OF TIME THE
APPLICANT HAS BEEN IN BUSINESS_______________________
OWNERSHIP: SOLE PROPRIETORSHIP _____ PARTNERSHIP _____
CORP______________
NAME OF OWNER (S)
____________________________(2nd)______________________
HOME ADDRESS OF OWNER (S)
______________________________________________
CITY _____________________ PROVINCE _______________ POSTAL ___________
NAME OF OFFICERS
________________________________________________________
NAME OF MANAGER
________________________________________________________
AUTHORIZED BUYER (S)
_____________________________________________________
AMOUNT OF CREDIT
REQUESTED_________________ Federal ID_______________
NAME OF BANK
_______________________________ ACCOUNT
# _______________
ADDRESS
____________________________________ BRANCH _________________
CITY _________________________________________ PROVINCE ________________
CREDIT CARD INFORMATION
-Visa________________________________Exp________________
BUSINESS REFERENCES Sales Tax No _____________ Social
Security No._____________
NAME _________________________________________________________________
ADDRESS
______________________________________ PHONE ( )____________
CITY ______________________
PROVINCE ______________ POSTAL ____________
NAME
__________________________________________________________________
ADDRESS
_______________________________________PHONE ( )___________
CITY ______________________
PROVINCE _______________ POSTAL ____________
NAME
__________________________________________________________________
ADDRESS
________________________________________PHONE ( )__________
CITY ______________________
PROVINCE _______________ POSTAL ____________
Credit Agreement
Applicant agrees to assume all responsibility for any and all
credit extended by
Tigullio/National Watersports and that delivery to carrier will constitute delivery to applicant. The
applicant agrees to pay a 1.5% service charge per month (equivalent to 18% per year) on all past
due invoices and a 15% restocking on all Authorized returned merchandise. The applicant further
agrees to pay all expense that the creditor deems necessary for collections of delinquent accounts,
including attorney fees. The applicant agrees that the merchandise remains the
VENDORS PROPERTY UNTIL PAID IN FULL
DATED AT ______________THIS
_____DAY OF ____, 19_____. Corp. Seal
SIGNATURE TITLE